REVIEW PAPER The cranial dura mater: a review of its history, embryology, and anatomy Nimer Adeeb & Martin M. Mortazavi & R. Shane Tubbs & Aaron A. Cohen-Gadol Received: 14 February 2012 / Accepted: 23 March 2012 / Published online: 15 April 2012 # Springer-Verlag 2012 Abstract Introduction The dura mater is important to the clinician as a barrier to the internal environment of the brain, and surgi- cally, its anatomy should be well known to the neurosurgeon and clinician who interpret imaging. Methods The medical literature was reviewed in regard to the morphology and embryology of specifically, the intra- cranial dura mater. A historic review of this meningeal layer is also provided. Conclusions Knowledge of the cranial dura mater has a rich history. The embryology is complex, and the surgical anat- omy of this layer and its specializations are important to the neurosurgeon. Keywords Anatomy . Cranium . Meninges . Dura mater . Surgery Introduction History The term meninges, singular meninx, a Greek term meaning “membrane,” was first used by Erasistratus in the third century B.C., to describe a membranous covering of the central nervous system. In the second century A.D., Galen described two layers, which he called the pacheia and the lepte. These were later observed and translated into Arabic by an anonymous Muslim physician as umm al-dimagh (mother of the brain), which was later subdivided by Hali Abbas into umm al-ghalida (hard mother) and umm al-raqiqah (thin mother). These terms were then literally translated into Latin by the twelfth century Italian monk Stephen of Antioch, as the dura (hard) mater (Fig. 1), and the pia (pious) mater. The term pia was a misnomer and should have been replaced by tenue (from tennus meaning thin), but the term pia has persisted. The first introduction of the word arachnoid (spider-like) mater was by Herophilus in the third century B.C., who also described its relation to the ventricles. It was later described by the Dutch anatomist Frederik Ruysch in the seventeenth century. The term mater is derived from ma- (from matru meaning mother) and the suffix -ter indicating a state of being [41, 53]. Embryology Since the first known description of the embryology of the meninges by Tiedemann and Münz [73] in 1816, many inves- tigations have been directed at describing its origin, including those of Bischoff [6] in 1842. Early investigators assumed that the cranial dura mater was derived from the ectoderm of the neural tube. However, histological studies such as those by Schwann [65] in 1839, described its connective tissue struc- ture, which suggests a different embryological origin. Later investigations by Kölliker [40] and His [28] and others described the origin of the meninges from a mesen- chymal tissue surrounding the neural tube, which was termed the “meninx primitiva” by Salvi [61] in 1898, and denied any contribution of the neural tube. This theory received acceptance from many investigators, including Sterzi [72] in 1901 and Farrer [18] in 1907. The meninx primitiva can be subdivided into two layers, the endomeninx (or secondary meninx), which contribute to the formation of the leptomeninx, and the ectomeninx, which contributes to the formation of the dura. This division is brought on by two cellular condensations as proposed by His [28]. N. Adeeb : M. M. Mortazavi : R. S. Tubbs (*) : A. A. Cohen-Gadol 1600 7th Ave South ACC 400, Birmingham, AL, USA e-mail: shane.tubbs@chsys.org Childs Nerv Syst (2012) 28:827–837 DOI 10.1007/s00381-012-1744-6