scholarly journals Anterior peri-insular quadrantotomy: a cadaveric white matter dissection study

2020 ◽  
Vol 25 (4) ◽  
pp. 331-339
Author(s):  
Pablo Gonzalez-Lopez ◽  
Giulia Cossu ◽  
Etienne Pralong ◽  
Matias Baldoncini ◽  
Mahmoud Messerer ◽  
...  
Keyword(s):  
White Matter ◽  
Motor Cortex ◽  
Frontal Lobe ◽  
Anterior Commissure ◽  
Internal Capsule ◽  
The Body ◽  
White Matter Tracts ◽  
Precise Understanding ◽  
Fiber Dissection ◽  
Dissection Techniques

OBJECTIVEAnterior quadrant disconnection represents a safe surgical option in well-selected pediatric patients with a large frontal lobe lesion anterior to the motor cortex. The understanding of the anatomy of the white matter tracts connecting the frontal lobe with the rest of the cerebrum forms the basis of a safe and successful disconnective surgery. The authors explored and illustrated the relevant white matter tracts sectioned during each surgical step using fiber dissection techniques.METHODSFive human cadaveric hemispheres were dissected to illustrate the frontal connections in the 3 planes. The dissections were performed from lateral to medial, medial to lateral, and ventral to dorsal to describe the various tracts sectioned during the 4 steps of this surgery, namely the anterior suprainsular window, intrafrontal disconnection, anterior callosotomy, and frontobasal disconnection.RESULTSAt the beginning of each surgical step, the U fibers were cut. During the anterior suprainsular window, the superior longitudinal fasciculus (SLF), the uncinate fasciculus, and the inferior fronto-occipital fasciculus (IFOF) were visualized and sectioned, followed by sectioning of the anterior limb of the internal capsule. During the intrafrontal disconnection, the SLF was cut, along with the corona radiata. At the medial surface the cingulum was sectioned. The anterior callosotomy disconnected the anterior third of the body of the callosum, the genu, and the rostrum. The frontobasal disconnection addressed the last remaining fibers connecting the frontal lobe with the rest of the hemisphere, namely the anterior limb of the anterior commissure.CONCLUSIONSThe anterior peri-insular quadrantotomy aims at effectively treating children with large lesions of the frontal lobe anterior to the motor cortex. A precise understanding of the gyral anatomy of this lobe along with the several white matter connections is crucial to avoid motor complications and to ensure complete disconnection.

scholarly journals The white matter tracts of the cerebrum in ventricular surgery and hydrocephalus

2017 ◽  
Vol 126 (3) ◽  
pp. 945-971 ◽  
Author(s):  
Abuzer Güngör ◽  
Serhat Baydin ◽  
Erik H. Middlebrooks ◽  
Necmettin Tanriover ◽  
Cihan Isler ◽  
...  
Keyword(s):  
White Matter ◽  
Anterior Commissure ◽  
Internal Capsule ◽  
Surgical Approaches ◽  
White Matter Tracts ◽  
Lateral Ventricles ◽  
Fiber Dissection ◽  
Dissection Technique ◽  
Relationship Of ◽  
The Relationship

OBJECTIVE The relationship of the white matter tracts to the lateral ventricles is important when planning surgical approaches to the ventricles and in understanding the symptoms of hydrocephalus. The authors' aim was to explore the relationship of the white matter tracts of the cerebrum to the lateral ventricles using fiber dissection technique and MR tractography and to discuss these findings in relation to approaches to ventricular lesions. METHODS Forty adult human formalin-fixed cadaveric hemispheres (20 brains) and 3 whole heads were examined using fiber dissection technique. The dissections were performed from lateral to medial, medial to lateral, superior to inferior, and inferior to superior. MR tractography showing the lateral ventricles aided in the understanding of the 3D relationships of the white matter tracts with the lateral ventricles. RESULTS The relationship between the lateral ventricles and the superior longitudinal I, II, and III, arcuate, vertical occipital, middle longitudinal, inferior longitudinal, inferior frontooccipital, uncinate, sledge runner, and lingular amygdaloidal fasciculi; and the anterior commissure fibers, optic radiations, internal capsule, corona radiata, thalamic radiations, cingulum, corpus callosum, fornix, caudate nucleus, thalamus, stria terminalis, and stria medullaris thalami were defined anatomically and radiologically. These fibers and structures have a consistent relationship to the lateral ventricles. CONCLUSIONS Knowledge of the relationship of the white matter tracts of the cerebrum to the lateral ventricles should aid in planning more accurate surgery for lesions within the lateral ventricles.

Anatomy of the Anterior Temporal Lobe and the Frontotemporal Region Demonstrated by Fiber Dissection

Neurosurgery ◽  
2004 ◽  
Vol 55 (5) ◽  
pp. 1174-1184 ◽  
Author(s):  
Diedrik Peuskens ◽  
Johannes van Loon ◽  
Frank Van Calenbergh ◽  
Raymond van den Bergh ◽  
Jan Goffin ◽  
...  
Keyword(s):  
White Matter ◽  
Temporal Lobe ◽  
Anterior Commissure ◽  
Three Dimensional ◽  
Dimensional Structure ◽  
Surgical Approaches ◽  
Anterior Temporal Lobe ◽  
White Matter Tracts ◽  
Fiber Dissection ◽  
Dissection Technique

Abstract OBJECTIVE: The white matter structure of the anterior temporal lobe and the frontotemporal region is complex and not well appreciated from the available neurosurgical literature. The fiber dissection method is an excellent means of attaining a thorough knowledge of the three-dimensional structure of the white matter tracts. This study was performed to demonstrate the usefulness of the dissection technique in understanding the white matter anatomy and the effects of current surgical approaches on the subcortical structure of the region. METHODS: Seventeen brain specimens obtained at routine autopsy were dissected by use of Klingler's fiber dissection technique after preparation by fixation and freezing. The dissections were performed with an operating microscope and followed a stepwise pattern of progressive white matter dissection. RESULTS: The dissection is described in an orderly fashion showing the white matter tracts of the anterior temporal lobe and the frontotemporal region. An insight is gained into the three-dimensional course of the anterior loop of the optic radiation, the temporal stem, the anterior commissure, and the ansa peduncularis. CONCLUSION: The anterior temporal lobe and the frontotemporal region contain several important white matter tracts that can be uniquely understood by performing a white matter dissection of the region. Surgical procedures on the anterior temporal lobe differ substantially as to their repercussions on the subcortical white matter tract anatomy, as shown by the findings in this study.

Microsurgical Anatomy of the White Matter Tracts in Hemispherotomy

2014 ◽  
Vol 10 (2) ◽  
pp. 305-324 ◽  
Author(s):  
Baris Kucukyuruk ◽  
Kaan Yagmurlu ◽  
Necmettin Tanriover ◽  
Mustafa Uzan ◽  
Albert L. Rhoton
Keyword(s):  
White Matter ◽  
Anterior Commissure ◽  
Posterior Part ◽  
Internal Capsule ◽  
Epileptic Seizures ◽  
Microsurgical Anatomy ◽  
Subcortical Structures ◽  
Posterior Edge ◽  
White Matter Tracts ◽  
Posterior Limb

Abstract BACKGROUND: Hemispherotomy is a surgical procedure performed for refractory epileptic seizures due to wide hemispheric damage. OBJECTIVE: To describe the microanatomy of the white matter tracts transected in a hemispherotomy and the relationship of the surgical landmarks used during the intraventricular callosotomy. METHODS: The cortical and subcortical structures were examined in 32 hemispheres. RESULTS: Incision of the temporal stem along the inferior limiting sulcus crosses the insulo-opercular fibers, uncinate, inferior occipitofrontal and middle longitudinal fasciculi, anterior commissure, and optic and auditory radiations. The incision along the superior limiting sulcus transects insulo-opercular fibers and the genu and posterior limb of internal capsule. The incision along the anterior limiting sulcus crosses the insulo-opercular fibers, anterior limb of the internal capsule, anterior commissure, and the anterior thalamic bundle. The disconnection of the posterior part of the corpus callosum may be incomplete if the point at which the last cortical branch of the anterior cerebral artery (ACA) turns upward and disappears from the view through the intraventricular exposure is used as the landmark for estimating the posterior extent of the callosotomy. This ACA branch turns upward before reaching the posterior edge of the splenium in 85% of hemispheres. The falx, followed to the posterior edge of the splenium, is a more reliable landmark for completing the posterior part of an intraventricular callosotomy. CONCLUSION: The fiber tracts disconnected in hemispherotomy were reviewed. The falx is a more reliable guide than the ACA in completing the posterior part of the intraventricular callosotomy.

Diffusion tensor tractography of the temporal stem on the inferior limiting sulcus

2008 ◽  
Vol 108 (4) ◽  
pp. 775-781 ◽  
Author(s):  
Feng Wang ◽  
Tao Sun ◽  
Xing-Gang Li ◽  
Na-Jia Liu
Keyword(s):  
White Matter ◽  
Diffusion Tensor ◽  
Anterior Commissure ◽  
Region Of Interest ◽  
Diffusion Tensor Tractography ◽  
Optic Radiation ◽  
Uncinate Fasciculus ◽  
White Matter Tracts ◽  
Temporal Horn ◽  
Temporal Stem

Object The aim of this study was to use diffusion tensor tractography (DTT) to define the 3D relationships of the uncinate fasciculus, anterior commissure, inferior occipitofrontal fasciculus, inferior thalamic peduncle, and optic radiation and to determine the positioning landmarks of these white matter tracts. Methods The anatomy was studied in 10 adult human brain specimens. Brain DTT was performed in 10 healthy volunteers. Diffusion tensor tractography images of the white matter tracts in the temporal stem were obtained using the simple single region of interest (ROI) and multi-ROIs based on the anatomical knowledge. Results The posteroinferior insular point is the anterior extremity of intersection of the Heschl gyrus and the inferior limiting sulcus. On the inferior limiting sulcus, this point is the posterior limit of the optic radiation, and the temporal stem begins at the limen insulae and ends at the posteroinferior insular point. The distance from the limen insulae to the tip of the temporal horn is just one third the length of the temporal stem. The uncinate fasciculus comprises the core of the anterior temporal stem, behind which the anterior commissure and the inferior thalamic peduncle are located, and they occupy the anterior third of the temporal stem. The inferior occipitofrontal fasciculus passes through the entire temporal stem. The most anterior extent of the Meyer loop is located between the anterior tip of the temporal horn and the limen insulae. Most of the optic radiation crosses the postmedian two thirds of the temporal stem. Conclusions On the inferior limiting sulcus, the posteroinferior insular point is a reliable landmark of the posterior limit of the optic radiations. The limen insulae, anterior tip of the temporal horn, and posteroinferior insular point may be used to localize the white matter fibers of the temporal stem in analyzing magnetic resonance imaging or during surgery.

scholarly journals Combining Hypothermia and Oleuropein Subacutely Protects Subcortical White Matter in a Swine Model of Neonatal Hypoxic-Ischemic Encephalopathy

2020 ◽  
Author(s):  
Jennifer K Lee ◽  
Polan T Santos ◽  
May W Chen ◽  
Caitlin E O’Brien ◽  
Ewa Kulikowicz ◽  
...  
Keyword(s):  
White Matter ◽  
Motor Cortex ◽  
Corpus Callosum ◽  
Internal Capsule ◽  
Subcortical White Matter ◽  
White Matter Injury ◽  
Swine Model ◽  
Cortex Neuron ◽  
Motor Cortex Neuron ◽  
Ischemic Encephalopathy

Abstract Neonatal hypoxia-ischemia (HI) causes white matter injury that is not fully prevented by therapeutic hypothermia. Adjuvant treatments are needed. We compared myelination in different piglet white matter regions. We then tested whether oleuropein (OLE) improves neuroprotection in 2- to 4-day-old piglets randomized to undergo HI or sham procedure and OLE or vehicle administration beginning at 15 minutes. All groups received overnight hypothermia and rewarming. Injury in the subcortical white matter, corpus callosum, internal capsule, putamen, and motor cortex gray matter was assessed 1 day later. At baseline, piglets had greater subcortical myelination than in corpus callosum. Hypothermic HI piglets had scant injury in putamen and cerebral cortex. However, hypothermia alone did not prevent the loss of subcortical myelinating oligodendrocytes or the reduction in subcortical myelin density after HI. Combining OLE with hypothermia improved post-HI subcortical white matter protection by preserving myelinating oligodendrocytes, myelin density, and oligodendrocyte markers. Corpus callosum and internal capsule showed little HI injury after hypothermia, and OLE accordingly had minimal effect. OLE did not affect putamen or motor cortex neuron counts. Thus, OLE combined with hypothermia protected subcortical white matter after HI. As an adjuvant to hypothermia, OLE may subacutely improve regional white matter protection after HI.

Microsurgical and Tractographic Anatomical Study of Transtemporal-Transchoroidal Fissure Approaches to the Ambient Cistern

2020 ◽  
Author(s):  
Emrah Egemen ◽  
Pinar Celtikci ◽  
Yücel Dogruel ◽  
Fatih Yakar ◽  
Defne Sahinoglu ◽  
...  
Keyword(s):  
White Matter ◽  
Anterior Commissure ◽  
Temporal Cortex ◽  
Anatomical Study ◽  
Middle Temporal Gyrus ◽  
Detailed Knowledge ◽  
Fiber Tractography ◽  
Human Connectome Project ◽  
Fiber Dissection ◽  
Ambient Cistern

Abstract BACKGROUND Approaching ambient cistern lesions is still a challenge because of deep location and related white matter tracts (WMTs) and neural structures. OBJECTIVE To investigate the white matter anatomy in the course of 3 types of transtemporal-transchoroidal fissure approaches (TTcFA) to ambient cistern by using fiber dissection technique with translumination and magnetic resonance imaging fiber tractography. METHODS Eight formalin-fixed cerebral hemispheres were dissected on surgical corridor from the temporal cortex to the ambient cistern by using Klingler's method. The trans-middle temporal gyrus, trans-inferior temporal sulcus (TITS), and trans-inferior temporal gyrus (TITG) approaches were evaluated. WMTs that were identified during dissection were then reconstructed on the Human Connectome Project 1021 individual template for validation. RESULTS The trans-middle gyrus approach interrupted the U fibers, arcuate fasciculus (AF), the ventral segment of inferior frontoocipital fasciculus (IFOF), the temporal extensions of the anterior commissure (AC) posterior crura, the tapetum (Tp) fibers, and the anterior loop of the optic radiation (OR). The TITS approach interrupted U fibers, inferior longitudinal fasciculus (ILF), IFOF, and OR. The TITG approach interrupted the U fibers, ILF, and OR. The middle longitudinal fasciculus, ILF, and uncinate fasciculus (UF) were not interrupted in the trans-middle gyrus approach and the AF, UF, AC, and Tp fibers were not interrupted in the TITS/gyrus approaches. CONCLUSION Surgical planning of the ambient cistern lesions requires detailed knowledge about WMTs. Fiber dissection and tractography techniques improve the orientation during surgery and may help decrease surgical complications.

scholarly journals Diffusion tensor imaging of frontal lobe white matter tracts in schizophrenia

2006 ◽  
Vol 5 (1) ◽  
Author(s):  
Monte S Buchsbaum ◽  
Peter Schoenknecht ◽  
Yuliya Torosjan ◽  
Randall Newmark ◽  
King-Wai Chu ◽  
...  
Keyword(s):  
Diffusion Tensor Imaging ◽  
White Matter ◽  
Frontal Lobe ◽  
Diffusion Tensor ◽  
White Matter Tracts

scholarly journals White Matter Microstructure Correlates of General and Specific Second-Order Factors of Psychopathology

2018 ◽  
Author(s):  
Kendra E. Hinton ◽  
Benjamin B. Lahey ◽  
Victoria Villalta-Gil ◽  
Francisco A. C. Meyer ◽  
Leah L. Burgess ◽  
...  
Keyword(s):  
White Matter ◽  
Corpus Callosum ◽  
Internal Capsule ◽  
Case Control ◽  
Second Order ◽  
The Body ◽  
General Factor ◽  
Diagnostic Categories ◽  
White Matter Microstructure ◽  
Control Designs

AbstractIncreasing data indicate that prevalent forms of psychopathology can be organized into second-order dimensions based on their correlations, including a general factor of psychopathology that explains the common variance among all disorders and specific second-order externalizing and internalizing factors. Despite this organization, and high levels of comorbidity between diagnoses, most existing studies on the neural correlates of psychopathology employ case-control designs that treat diagnoses as independent categories. Thus, for instance, although perturbations in white matter microstructure have been identified across a range of disorders, the majority of such studies have used case-control designs, leaving it unclear whether observed relations reflect disorder specific characteristics, or transdiagnostic patterns. Using a representative community twin sample of 410 young adults, we tested the hypothesis that some relations between white matter microstructure properties in major tracts are related to second-order factors of psychopathology. We examined fractional anisotropy (FA), radial diffusivity (RD), and axial diffusivity (AD). White matter correlates of all second-order factors were identified after controlling for multiple tests, including the general factor (FA in the body of the corpus callosum), specific internalizing (AD in the fornix), and specific externalizing (AD in the splenium of the corpus callosum, sagittal stratum, anterior corona radiata, and internal capsule). These findings suggest that features of white matter within specific tracts are associated with broad transdiagnostic dimensions of psychopathology rather than being restricted to individual diagnostic categories.

Diffusion tensor imaging in neonatal encephalopathy: a systematic review

2019 ◽  
Vol 105 (5) ◽  
pp. 480-488 ◽  
Author(s):  
Megan Dibble ◽  
Mary Isabel O'Dea ◽  
Tim Hurley ◽  
Angela Byrne ◽  
Gabrielle Colleran ◽  
...  
Keyword(s):  
Diffusion Tensor Imaging ◽  
White Matter ◽  
Diffusion Tensor ◽  
Neurodevelopmental Outcome ◽  
Internal Capsule ◽  
Adverse Outcomes ◽  
Restricted Diffusion ◽  
Neonatal Encephalopathy ◽  
White Matter Tracts ◽  
Posterior Limb

Background and objectiveDiffusion tensor imaging (DTI) during the first few days of life can be used to assess brain injury in neonates with neonatal encephalopathy (NE) for outcome prediction. The goal of this review was to identify specific white matter tracts of interest that can be quantified by DTI as being altered in neonates with this condition, and to investigate its potential prognostic ability.MethodsSearches of Medline and the Cochrane Database of Systematic Reviews were conducted to identify studies with diffusion data collected in term-born neonates with NE.Results19 studies were included which described restricted diffusion in encephalopathic neonates as compared with healthy controls, with the posterior limb of the internal capsule and the genu and splenium of the corpus callosum identified as particular regions of interest. Restricted diffusion was related to adverse outcomes in the studies that conducted a follow-up of these infants.ConclusionsObtaining diffusion measures in these key white matter tracts early in life before pseudonormalisation can occur can not only identify the extent of the damage but also can be used to examine the effectiveness of treatment and to predict neurodevelopmental outcome.

scholarly journals Focal Increases of White Matter Glucose Utilization Produced by Electrical Stimulation of Rat Motor Cortex

1983 ◽  
Vol 3 (1) ◽  
pp. 67-70 ◽  
Author(s):  
Frank R. Sharp ◽  
Sherzad Bzorgchami ◽  
Thomas Kilduff
Keyword(s):  
Electrical Stimulation ◽  
White Matter ◽  
Motor Cortex ◽  
Glucose Utilization ◽  
Pyramidal Tract ◽  
Internal Capsule ◽  
Local Cerebral Glucose Utilization ◽  
The Right ◽  
Deoxyglucose Method ◽  
Stimulation Of

The right motor cortex was electrically stimulated in adult, awake rats for 45 min. Local cerebral glucose utilization (LCGU) was measured in white matter pathways with the (14C)-2-deoxyglucose method. Stimulation increased LCGU in focal regions of the right internal capsule to 51.3 μmol/100 g/min, compared to 39.8 on the control left side. Stimulation also increased LCGU in the right, medial pontine pyramidal tract to 36.2 μmol/100 g/min, compared with 27.3 on the control left side. The data demonstrate that electrical stimulation of motor cortex neurons increases LCGU 30 to 40% in the efferent myelinated axons of those neurons.

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