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Anatomical aspects of the insula, opercula and peri-insular white matter for a transcortical approach to insular glioma resection
The insula is a lobe located deep in each hemisphere of the brain and is surrounded by eloquent cortical, white matter, and basal ganglia structures. The aim of this study was to provide an anatomical description of the insula and white matter tracts related to surgical treatment of gliomas through...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Springer Berlin Heidelberg
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8827298/ https://www.ncbi.nlm.nih.gov/pubmed/34292438 http://dx.doi.org/10.1007/s10143-021-01602-5 |
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author | Dziedzic, Tomasz Andrzej Bala, Aleksandra Marchel, Andrzej |
author_facet | Dziedzic, Tomasz Andrzej Bala, Aleksandra Marchel, Andrzej |
author_sort | Dziedzic, Tomasz Andrzej |
collection | PubMed |
description | The insula is a lobe located deep in each hemisphere of the brain and is surrounded by eloquent cortical, white matter, and basal ganglia structures. The aim of this study was to provide an anatomical description of the insula and white matter tracts related to surgical treatment of gliomas through a transcortical approach. The study also discusses surgical implications in terms of intraoperative brain mapping. Five adult brains were prepared according to the Klingler technique. Cortical anatomy was evaluated with the naked eye, whereas white matter dissection was performed with the use of a microscope. The widest exposure of the insular surface was noted through the temporal operculum, mainly in zones III and IV according to the Berger-Sanai classification. By going through the pars triangularis in all cases, the anterior insular point and most of zone I were exposed. The narrowest and deepest operating field was observed by going through the parietal operculum. This method provided a suitable approach to zone II, where the corticospinal tract is not covered by the basal ganglia and is exposed just under the superior limiting sulcus. At the subcortical level, the identification of the inferior frontoocipital fasciculus at the level of the limen insulae is critical in terms of preserving the lenticulostriate arteries. Detailed knowledge of the anatomy of the insula and subcortical white matter that is exposed through each operculum is essential in preoperative planning as well as in the intraoperative decision-making process in terms of intraoperative brain mapping. |
format | Online Article Text |
id | pubmed-8827298 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-88272982022-02-23 Anatomical aspects of the insula, opercula and peri-insular white matter for a transcortical approach to insular glioma resection Dziedzic, Tomasz Andrzej Bala, Aleksandra Marchel, Andrzej Neurosurg Rev Original Article The insula is a lobe located deep in each hemisphere of the brain and is surrounded by eloquent cortical, white matter, and basal ganglia structures. The aim of this study was to provide an anatomical description of the insula and white matter tracts related to surgical treatment of gliomas through a transcortical approach. The study also discusses surgical implications in terms of intraoperative brain mapping. Five adult brains were prepared according to the Klingler technique. Cortical anatomy was evaluated with the naked eye, whereas white matter dissection was performed with the use of a microscope. The widest exposure of the insular surface was noted through the temporal operculum, mainly in zones III and IV according to the Berger-Sanai classification. By going through the pars triangularis in all cases, the anterior insular point and most of zone I were exposed. The narrowest and deepest operating field was observed by going through the parietal operculum. This method provided a suitable approach to zone II, where the corticospinal tract is not covered by the basal ganglia and is exposed just under the superior limiting sulcus. At the subcortical level, the identification of the inferior frontoocipital fasciculus at the level of the limen insulae is critical in terms of preserving the lenticulostriate arteries. Detailed knowledge of the anatomy of the insula and subcortical white matter that is exposed through each operculum is essential in preoperative planning as well as in the intraoperative decision-making process in terms of intraoperative brain mapping. Springer Berlin Heidelberg 2021-07-22 2022 /pmc/articles/PMC8827298/ /pubmed/34292438 http://dx.doi.org/10.1007/s10143-021-01602-5 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Dziedzic, Tomasz Andrzej Bala, Aleksandra Marchel, Andrzej Anatomical aspects of the insula, opercula and peri-insular white matter for a transcortical approach to insular glioma resection |
title | Anatomical aspects of the insula, opercula and peri-insular white matter for a transcortical approach to insular glioma resection |
title_full | Anatomical aspects of the insula, opercula and peri-insular white matter for a transcortical approach to insular glioma resection |
title_fullStr | Anatomical aspects of the insula, opercula and peri-insular white matter for a transcortical approach to insular glioma resection |
title_full_unstemmed | Anatomical aspects of the insula, opercula and peri-insular white matter for a transcortical approach to insular glioma resection |
title_short | Anatomical aspects of the insula, opercula and peri-insular white matter for a transcortical approach to insular glioma resection |
title_sort | anatomical aspects of the insula, opercula and peri-insular white matter for a transcortical approach to insular glioma resection |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8827298/ https://www.ncbi.nlm.nih.gov/pubmed/34292438 http://dx.doi.org/10.1007/s10143-021-01602-5 |
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