Topics

Topic

design image
Quadrigeminal cistern

The Quadrigeminal cistern is a cerebrospinal fluid (CSF)-filled space located in the midline at the dorsal aspect of the midbrain, posterior to the colliculi (tectal plate), and superior to the cerebellum. It is an important subarachnoid cistern, forming part of the perimesencephalic cisterns. The cistern contains several crucial neurovascular structures and serves as a key landmark in neuroimaging. The quadrigeminal cistern communicates with adjacent cisterns, including the ambient cisterns laterally and the superior cerebellar cistern inferiorly.

Synonyms:

  • Cistern of the great cerebral vein

  • Superior cistern

  • Cisterna quadrigeminalis

  • Pretectal cistern (less commonly used)

Function:

  • Acts as a reservoir and conduit for cerebrospinal fluid (CSF) circulation in the subarachnoid space.

  • Cushions and protects neurovascular structures located within and around the midbrain.

  • Contains important neurovascular structures including:

    • Great cerebral vein (vein of Galen)

    • Posterior cerebral arteries

    • Superior cerebellar arteries

    • Trochlear nerves (CN IV)

    • Pineal gland (located anteriorly within the cistern)

  • Provides an anatomical landmark for neurosurgical approaches and radiological evaluation of pathologies such as pineal region tumors, arachnoid cysts, or hemorrhage.

MRI Appearance:

  • T1-weighted:

    • Appears as a hypointense (dark) space due to CSF signal.

    • Neurovascular structures within may be seen as flow voids or signal-void dots/lines.

    • Pineal gland may appear isointense to brain parenchyma.

  • T2-weighted:

    • Hyperintense (bright) area reflecting the high water content of CSF.

    • Internal structures such as vessels and the pineal gland may appear as hypointense foci.

  • FLAIR:

    • Cistern is hypointense (dark) as CSF signal is suppressed.

    • Pathologies such as blood, proteinaceous fluid, or tumors may appear hyperintense (bright), helping distinguish them from normal CSF.

CT Appearance:

  • Appears as a well-defined, low-density (hypodense) space posterior to the midbrain and superior to the cerebellum.

  • CSF in the cistern is the same attenuation as other CSF spaces.

  • Structures such as the pineal gland may be visible as a small calcification anteriorly.

  • Pathologies (e.g., hemorrhage, masses) may alter the normal low-density appearance.

MRI images

Quadrigeminal cistern; Cistern of great cerebral vein mri 3t coronal image

MRI images

Quadrigeminal cistern; Cistern of great cerebral vein mri 3t sagittal image

CT image

Quadrigeminal cistern CT sag anatomy image -img-00001-00001