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Folia Morphol (Warsz). 2021 Nov 03; doi: 10.5603/FM.a2021.0114. Epub 2021 Nov 03.

The posterior cranial fossa's dura mater innervation and its clinical implication in headache: a comprehensive review.

Folia morphologica

D Hage, M Mathkour, J Iwanaga, A S Dumont, R S Tubbs

Affiliations

  1. Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA.
  2. Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA. [email protected].
  3. Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA. [email protected].
  4. Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA.
  5. Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA.
  6. Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, USA.
  7. Department of Anatomical Sciences, St. George's University, St. George's, Grenada.

PMID: 34730227 DOI: 10.5603/FM.a2021.0114

Abstract

The pathophysiology of migraines and headaches has been a point of interest in research as they affect a large subset of the population, and the exact mechanism is still unclear. There is evidence implicating the dura mater and its innervation as contributing factors, especially at the posterior cranial fossa. Many modes of innervation have been identified, including the dorsal root ganglion (DRG), superior cervical ganglion, vagus nerve, trigeminal nerve, hypoglossal nerve, and glossopharyngeal nerve. While the exact method of innervation is still under investigation, there is strong evidence suggesting that different types of headaches (migraine vs. occipital vs. cervicogenic) are due to specific nerves and inflammatory mediators that contribute to the dura mater in some way. By understanding how these innervation patterns manifest clinically, the course of treatment can be tailored based on the physiological etiology. Here, we present a comprehensive literature review of the current research regarding the innervation of the dura mater of the posterior cranial fossa and its clinical implications.

Keywords: anatomy; cranium; headache; meninges; nerves

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