Innervation of the meninges

The sensory innervation of the meninges is primarily by meningeal branches of both the trigeminal and vagus nerves with a smaller contribution from the upper cervical spinal nerves ^1,2. The supratentorial dura mater is mainly supplied by the ophthalmic division of the trigeminal nerve ³. Like the arterial supply, innervation is dependent on the site of the dura.

Innervation

The dominant nerve supplying most of the supratenotrial dura is the tentorial nerve (a branch of the ophthalmic nerve (CN Va)) which supplies the falx, calvarial dura and superior surface of the tentorium.

Anterior cranial fossa

• meningeal branches from the anterior and posterior ethmoidal nerves ^1,3, off the nasociliary nerve from the ophthalmic division of the trigeminal nerve
• meningeal branches from the maxillary nerve (CN Vb)

Middle cranial fossa

• meningeal branches of ophthalmic, maxillary and mandibular divisions of trigeminal nerve ^1,2
• tentorial branches of the ophthalmic and maxillary divisions of the trigeminal nerve extend posteriorly from the anterior end of the cavernous sinus to the upper surface of the tentorium cerebelli ¹
• middle meningeal nerve (a branch off the maxillary nerve (CN Vb) supplies the anterior parts of the fossa
• meningeal branch of the mandibular nerve (CN Vc) supplies the posterior parts of the fossa

Posterior cranial fossa

• sensory meningeal branches from the vagus nerve (CN X) and glossopharyngeal nerve (CN IX) supply the inferior surface of the tentorium and dura of the posterior fossa
• small sensory branches of the C1 to C3 dorsal rami supply around the foramen magnum

Related pathology

• meningitis
• post lumbar puncture headache ⁴