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Cisterna magna

The largest of the subarachnoid cisterns.

The two other principal cisterns are the pontine cistern located between the pons and the medulla, and the interpeduncular cistern located between the cerebral peduncles.

The cisterna magna (or cerebellomedullary cistern) is one of three principal openings in the subarachnoid space between the arachnoid and pia mater layers of the meninges surrounding the brain. The openings are collectively referred to as cisterns. The cisterna magna is located between the cerebellum and the dorsal surface of the medulla oblongata. Cerebrospinal fluid produced in the fourth ventricle drains into the cisterna magna via the lateral apertures and median aperture.

It receives CSF from the fourth ventricle via the median foramen of Magendie and the paired lateral foramen of Luschka.

Content

The vertebral artery and the origin of the posterior inferior cerebellar artery (PICA).

The ninth (IX), tenth (X), eleventh (XI) and twelfth (XII) cranial nerves.

The choroid plexus.

Cerebral spinal fluid can also be obtained by puncture of the cisterna magna (cistern puncture).

Combined unilateral trans cerebellomedullary fissure (CMF), /lateral foramen magnum approaches provide a wide and close surgical field in the cerebellomedullary cistern (CMC), allowing easy and safe CMC surgery 1).

Giant cisterna magna

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Panventriculomegaly with a wide foramen of Magendie and a large cisterna magna may belong to a subtype of congenital hydrocephalus with familial accumulation, younger age at onset, and symptoms of normal pressure hydrocephalus. In addition, a family with PaVM has a gene mutation associated with dysfunction of motile cilia 2).

Cisterna magna meningioma

see Cisterna magna meningioma.

1)
Matsushima T, Kawashima M, Inoue K, Matsushima K, Miki K. Exposure of Wide Cerebellomedullary Cisterns for Vascular Lesion Surgeries in Cerebellomedullary Cisterns: Opening of Unilateral Cerebellomedullary Fissures Combined with Lateral Foramen Magnum Approach. World Neurosurg. 2014 Apr 30. pii: S1878-8750(14)00447-1. doi: 10.1016/j.wneu.2014.04.064. [Epub ahead of print] Review. PubMed PMID: 24793562.
2)
Kageyama H, Miyajima M, Ogino I, Nakajima M, Shimoji K, Fukai R, Miyake N, Nishiyama K, Matsumoto N, Arai H. Panventriculomegaly with a wide foramen of Magendie and large cisterna magna. J Neurosurg. 2016 Jun;124(6):1858-66. doi: 10.3171/2015.6.JNS15162. Epub 2015 Dec 4. PubMed PMID: 26636390.