Interdural high signal on CISS sequence: an alternative CSF pathway?

  • Satoshi TsutsumiEmail author
  • Hideo Ono
  • Hisato Ishii
  • Yukimasa Yasumoto
Original Article



The falx cerebri, falx cerebelli, and tentorial notch exhibit a peculiar morphology with a two-layered, dural leaf that protrudes into the cranial cavity with a free edge. However, there are few studies exploring this morphology using neuroimaging techniques. The present study aimed to explore these dural structures using magnetic resonance imaging.


A total of 65 outpatients were included in this study. Following initial examinations with conventional sequences, the constructive interference in steady-state (CISS) sequences were performed in thin-sliced, coronal sections.


In 78% of the subjects, the interdural spaces presenting with high signal were identified in the falx cerebri. These spaces were located adjacent to the uppermost part of the falx, formed by two dural leaves and the superior sagittal sinus, and tapered downward where the leaves united to form the falx cerebri. At the tentorial notch, these spaces were found in 52% of the 65, most predominantly in the medial edge followed by the tentorium cerebelli-tentorial notch junctional region. Forty-one percent of patients had a dural opening into the cerebral cistern. The interdural spaces with high signal were not identified in the tentorium cerebelli in any of the subjects.


The falx cerebri and tentorial notch form the interdural spaces that may provide alternative cerebrospinal fluid pathways. The coronal CISS sequence is suitable for delineating such interdural spaces.


Interdural spaces Falx cerebri Tentorium cerebelli CSF pathway CISS sequence 


Authors’ contribution to the manuscript

Satoshi Tsutsumi and Hideo Ono developed the study project.

Yukimasa Yasumoto was involved in data collection and management.

Satoshi Tsutsumi and Hisato Ishii analyzed the data.

Satoshi Tsutsumi wrote the manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Satoshi Tsutsumi
    • 1
    Email author
  • Hideo Ono
    • 2
  • Hisato Ishii
    • 1
  • Yukimasa Yasumoto
    • 1
  1. 1.Department of Neurological SurgeryJuntendo University Urayasu HospitalChibaJapan
  2. 2.Division of Radiological TechnologyMedical Satellite Yaesu ClinicTokyoJapan

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