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Cadaveric White Matter Dissection Study of the Telencephalic Flexure: Surgical Implications

Neurosurgery has traditionally been overtly focused on the study of anatomy and functions of cortical areas with microsurgical techniques aimed at preserving eloquent cortices. In the last two decades, there has been ever-increasing data emerging from advances in neuroimaging (principally diffusion...

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Autores principales: González-López, Pablo, Cossu, Giulia, Thomas, Cynthia M., Marston, Jeffery S., Gómez, Cristina, Pralong, Etienne, Messerer, Mahmoud, Daniel, Roy T.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8886146/
https://www.ncbi.nlm.nih.gov/pubmed/35242095
http://dx.doi.org/10.3389/fneur.2022.757757
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author González-López, Pablo
Cossu, Giulia
Thomas, Cynthia M.
Marston, Jeffery S.
Gómez, Cristina
Pralong, Etienne
Messerer, Mahmoud
Daniel, Roy T.
author_facet González-López, Pablo
Cossu, Giulia
Thomas, Cynthia M.
Marston, Jeffery S.
Gómez, Cristina
Pralong, Etienne
Messerer, Mahmoud
Daniel, Roy T.
author_sort González-López, Pablo
collection PubMed
description Neurosurgery has traditionally been overtly focused on the study of anatomy and functions of cortical areas with microsurgical techniques aimed at preserving eloquent cortices. In the last two decades, there has been ever-increasing data emerging from advances in neuroimaging (principally diffusion tensor imaging) and clinical studies (principally from awake surgeries) that point to the important contribution of white matter tracts (WMT) that influence neurological function as part of a brain network. Major scientific consortiums worldwide, currently working on this human brain connectome, are providing evidence that is dramatically altering the manner in which we view neurosurgical procedures. The development of the telencephalic flexure, a major landmark during the human embryogenesis of the central nervous system (CNS), severely affects the cortical/subcortical anatomy in and around the sylvian fissure and thus the different interacting brain networks. Indeed, the telencephalic flexure modifies the anatomy of the human brain with the more posterior areas becoming ventral and lateral and associative fibers connecting the anterior areas with the previous posterior ones follow the flexure, thus becoming semicircular. In these areas, the projection, association, and commissural fibers intermingle with some WMT remaining curved and others longitudinal. Essentially the ultimate shape and location of these tracts are determined by the development of the telencephalic flexure. Five adult human brains were dissected (medial to lateral and lateral to medial) with a view to describing this intricate anatomy. To better understand the 3D orientation of the WMT of the region we have correlated the cadaveric data with the anatomy presented in the literature of the flexure during human neuro-embryogenesis in addition to cross-species comparisons of the flexure. The precise definition of the connectome of the telencephalic flexure is primordial during glioma surgery and for disconnective epilepsy surgery in this region.
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spelling pubmed-88861462022-03-02 Cadaveric White Matter Dissection Study of the Telencephalic Flexure: Surgical Implications González-López, Pablo Cossu, Giulia Thomas, Cynthia M. Marston, Jeffery S. Gómez, Cristina Pralong, Etienne Messerer, Mahmoud Daniel, Roy T. Front Neurol Neurology Neurosurgery has traditionally been overtly focused on the study of anatomy and functions of cortical areas with microsurgical techniques aimed at preserving eloquent cortices. In the last two decades, there has been ever-increasing data emerging from advances in neuroimaging (principally diffusion tensor imaging) and clinical studies (principally from awake surgeries) that point to the important contribution of white matter tracts (WMT) that influence neurological function as part of a brain network. Major scientific consortiums worldwide, currently working on this human brain connectome, are providing evidence that is dramatically altering the manner in which we view neurosurgical procedures. The development of the telencephalic flexure, a major landmark during the human embryogenesis of the central nervous system (CNS), severely affects the cortical/subcortical anatomy in and around the sylvian fissure and thus the different interacting brain networks. Indeed, the telencephalic flexure modifies the anatomy of the human brain with the more posterior areas becoming ventral and lateral and associative fibers connecting the anterior areas with the previous posterior ones follow the flexure, thus becoming semicircular. In these areas, the projection, association, and commissural fibers intermingle with some WMT remaining curved and others longitudinal. Essentially the ultimate shape and location of these tracts are determined by the development of the telencephalic flexure. Five adult human brains were dissected (medial to lateral and lateral to medial) with a view to describing this intricate anatomy. To better understand the 3D orientation of the WMT of the region we have correlated the cadaveric data with the anatomy presented in the literature of the flexure during human neuro-embryogenesis in addition to cross-species comparisons of the flexure. The precise definition of the connectome of the telencephalic flexure is primordial during glioma surgery and for disconnective epilepsy surgery in this region. Frontiers Media S.A. 2022-02-15 /pmc/articles/PMC8886146/ /pubmed/35242095 http://dx.doi.org/10.3389/fneur.2022.757757 Text en Copyright © 2022 González-López, Cossu, Thomas, Marston, Gómez, Pralong, Messerer and Daniel. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
González-López, Pablo
Cossu, Giulia
Thomas, Cynthia M.
Marston, Jeffery S.
Gómez, Cristina
Pralong, Etienne
Messerer, Mahmoud
Daniel, Roy T.
Cadaveric White Matter Dissection Study of the Telencephalic Flexure: Surgical Implications
title Cadaveric White Matter Dissection Study of the Telencephalic Flexure: Surgical Implications
title_full Cadaveric White Matter Dissection Study of the Telencephalic Flexure: Surgical Implications
title_fullStr Cadaveric White Matter Dissection Study of the Telencephalic Flexure: Surgical Implications
title_full_unstemmed Cadaveric White Matter Dissection Study of the Telencephalic Flexure: Surgical Implications
title_short Cadaveric White Matter Dissection Study of the Telencephalic Flexure: Surgical Implications
title_sort cadaveric white matter dissection study of the telencephalic flexure: surgical implications
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8886146/
https://www.ncbi.nlm.nih.gov/pubmed/35242095
http://dx.doi.org/10.3389/fneur.2022.757757
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