MENINGEAL TENSION: PULLING THE ENVELOPE
From the top of the brain to the end of
the spine, a tube of connective tissue envelopes encases the central nervous system. These
envelopes are known as the "meninges" (from a Greek word meaning
"membranes"). Within the meninges, one finds a series of barriers to infectious
organisms and toxins - "the blood-brain barrier". Once blood plasma is purified
through this barrier, it bathes the brain and spinal cord with nutrients. This purified
substance is called the "cerebrospinal fluid".
The outermost layer of the meninges is a
tough fibrous structure called the "dura mater" (Latin for "tough
mother"). As nerves exit the spine, they are accompanied by extensions of the dura
mater - the "dural sleeves". Abnormal tension along the dura mater can have
widespread consequences due to the potential effect on the spinal nerves and the flow of
In 1995 a team of anatomists at the
University of Maryland found a connective tissue bridge between the dura mater and the
small muscles of the upper neck.1 Among other things, this connection could
help explain why so many people with joint problems in the upper portion of the neck
(upper cervical subluxation) suffer from headache. In a recent Encyclopedia Britannica
publication, the following observations were made regarding chiropractic adjustments for
headache patients in light of this new discovery: "Such treatment, as performed by a
chiropractor, would decrease muscle tension and thereby reduce or eliminate pain by
reducing the potential forces exerted on the dura mater via the muscle-dura
In 1998 a team of anatomists at
Anglo-European College of Chiropractic reported another important connection between the
dura mater and the neck.3 One of the major stabilizing ligaments of the neck
(the "ligamentum nuchae") runs along the back of the cervical vertebrae. The
chiropractic team discovered a branch of this ligament that passes between the first two
cervical vertebrae and attaches to the dura mater. Rigidity of this ligament is often
found in patients with neck trauma or subluxation. In light of their new findings, the
investigators reason that this ligamentous rigidity can create adverse tension in the dura
mater. They suggest that this dural tension can lead to neck pain, headache, weakness in
the arms, memory loss and disturbances in concentration.
Many people believe that todays
clinical sciences can only move forward with electron microscopes, computerized imaging,
and large-scale controlled experiments. In this atmosphere it is important to remember
that anatomy is the queen of the clinical sciences. In the hands of careful observers, the
modest tools of the ordinary dissection kit can still reveal important new findings.
1 Hack GD, et al. "Anatomic
Relation Between the Rectus Capitib Posterior Minor Muscle and the Dura Mater".
Spine, 1995; 20: 2484 - 24-84.
2 Hack GD, et al. "The
Anatomist's New Tools". In Bernstein E (ed). 1998 Medical and Health Annual.
Encyclopedia Britannica, 1997.
3 Mitchell BS, et al.
"Attachments of the Ligamentum Nuchae to Cervical Posterior Dura and the Lateral Part
of the Occipital Bone." Journal of Manipulative and Physiological Therapeutics, 1998;
21: 145 - 148.
© 1998, All Rights
Marion Todres, M.A., D.C. and Charles Masarsky, D.C.