Please use this identifier to cite or link to this item:
Full metadata record
DC FieldValueLanguage
dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP-
dc.contributor.authorRIBAS, Eduardo Carvalhal-
dc.contributor.authorYAGMURLU, Kaan-
dc.contributor.authorOLIVEIRA, Evandro de-
dc.contributor.authorRIBAS, Guilherme Carvalhal-
dc.contributor.authorRHOTON JR., Albert-
dc.identifier.citationJOURNAL OF NEUROSURGERY, v.129, n.3, p.752-769, 2018-
dc.description.abstractOBJECTIVE The purpose of this study was to describe in detail the cortical and subcortical anatomy of the central core of the brain, defining its limits, with particular attention to the topography and relationships of the thalamus, basal ganglia, and related white matter pathways and vessels. METHODS The authors studied 19 cerebral hemispheres. The vascular systems of all of the specimens were injected with colored silicone, and the specimens were then frozen for at least 1 month to facilitate identification of individual fiber tracts. The dissections were performed in a stepwise manner, locating each gray matter nucleus and white matter pathway at different depths inside the central core. The course of fiber pathways was also noted in relation to the insular limiting sulci. RESULTS The insular surface is the most superficial aspect of the central core and is divided by a central sulcus into an anterior portion, usually containing 3 short gyri, and a posterior portion, with 2 long gyri. It is bounded by the anterior limiting sulcus, the superior limiting sulcus, and the inferior limiting sulcus. The extreme capsule is directly underneath the insular surface and is composed of short association fibers that extend toward all the opercula. The claustrum lies deep to the extreme capsule, and the external capsule is found medial to it. Three fiber pathways contribute to form both the extreme and external capsules, and they lie in a sequential anteroposterior disposition: the uncinate fascicle, the inferior fronto-occipital fascicle, and claustrocortical fibers. The putamen and the globus pallidus are between the external capsule, laterally, and the internal capsule, medially. The internal capsule is present medial to almost all insular limiting sulci and most of the insular surface, but not to their most anteroinferior portions. This anteroinferior portion of the central core has a more complex anatomy and is distinguished in this paper as the ""anterior perforated substance region."" The caudate nucleus and thalamus lie medial to the internal capsule, as the most medial structures of the central core. While the anterior half of the central core is related to the head of the caudate nucleus, the posterior half is related to the thalamus, and hence to each associated portion of the internal capsule between these structures and the insular surface. The central core stands on top of the brainstem. The brainstem and central core are connected by several white matter pathways and are not separated from each other by any natural division. The authors propose a subdivision of the central core into quadrants and describe each in detail. The functional importance of each structure is highlighted, and surgical approaches are suggested for each quadrant of the central core. CONCLUSIONS As a general rule, the internal capsule and its vascularization should be seen as a parasagittal barrier with great functional importance. This is of particular importance in choosing surgical approaches within this region.-
dc.description.sponsorshipUniversity of Florida Foundation-
dc.relation.ispartofJournal of Neurosurgery-
dc.subjectcentral core-
dc.subjectanterior commissure-
dc.subjectclaustrocortical fibers-
dc.subjectinternal capsule-
dc.subjectinferior fronto-occipital fascicle-
dc.subjectuncinate fascicle-
dc.subject.otherfunctional connectivity-
dc.subject.otherlanguage pathways-
dc.subject.otherfiber dissection-
dc.subject.othertemporal stem-
dc.subject.otherbasal ganglia-
dc.titleMicrosurgical anatomy of the central core of the brain-
dc.subject.wosClinical Neurology-
dc.type.categoryoriginal article-
dc.type.versionpublishedVersion-, Kaan:Univ Florida, Dept Neurosurg, Gainesville, FL USA-, Evandro de:Inst Neurol Sci, Sao Paulo, SP, Brazil; Mayo Clin, Dept Neurol Surg, Jacksonville, FL 32224 USA- JR., Albert:Univ Florida, Dept Neurosurg, Gainesville, FL USA-
hcfmusp.publisher.cityROLLING MEADOWS-
hcfmusp.relation.referenceALEXANDER GE, 1986, ANNU REV NEUROSCI, V9, P357, DOI 10.1146/
hcfmusp.relation.referenceBroca P, 1877, B SOC ANTH, V12, P646-
hcfmusp.relation.referenceChang EF, 2011, J NEUROSURG, V114, P814, DOI 10.3171/2010.5.JNS091159-
hcfmusp.relation.referenceChoi CY, 2011, J NEUROSURG, V114, P463, DOI 10.3171/2010.9.JNS10530-
hcfmusp.relation.referencede Olmos JS, 1999, ANN NY ACAD SCI, V877, P1-
hcfmusp.relation.referenceDuffau H, 2002, J NEUROSURG, V97, P363, DOI 10.3171/jns.2002.97.2.0363-
hcfmusp.relation.referenceDuffau H, 2002, BRAIN, V125, P199, DOI 10.1093/brain/awf016-
hcfmusp.relation.referenceDuffau H, 2005, BRAIN, V128, P797, DOI 10.1093/brain/awh423-
hcfmusp.relation.referenceDuffau H, 2008, J NEUROSURG, V109, P461, DOI 10.3171/JNS/2008/109/9/0461-
hcfmusp.relation.referenceDuffau H, 2008, NEUROPSYCHOLOGIA, V46, P927, DOI 10.1016/j.neuropsychologia.2007.10.025-
hcfmusp.relation.referenceDuffau H, 2009, J NEUROL, V256, P382, DOI 10.1007/s00415-009-0053-9-
hcfmusp.relation.referenceEBELING U, 1992, ACTA NEUROCHIR, V118, P164, DOI 10.1007/BF01401303-
hcfmusp.relation.referenceFederative Committee on Anatomical Terminology, 1998, TERM AN INT AN TERM-
hcfmusp.relation.referenceGlosser G, 2003, NEUROLOGY, V61, P81, DOI 10.1212/01.WNL.0000073621.18013.E1-
hcfmusp.relation.referenceGray H, 2005, GRAYS ANATOMY ANATOM-
hcfmusp.relation.referenceHEIMER L, 1995, HUMAN BRAIN SPINAL C-
hcfmusp.relation.referenceHOREL JA, 1976, SCIENCE, V193, P337, DOI 10.1126/science.819992-
hcfmusp.relation.referenceHOREL JA, 1978, BRAIN, V101, P403, DOI 10.1093/brain/101.3.403-
hcfmusp.relation.referenceKlingler J, 1935, SCHWEIZ ARCH NEUROL, V36, P247-
hcfmusp.relation.referenceKumabe T, 2007, J NEUROSURG, V106, P263, DOI 10.3171/jns.2007.106.2.263-
hcfmusp.relation.referenceLu LH, 2002, NEUROPSYCHOLOGIA, V40, P1608, DOI 10.1016/S0028-3932(02)00014-3-
hcfmusp.relation.referenceLudwig E, 1956, ATLAS CEREBRI HUMANI-
hcfmusp.relation.referenceMachado A, 2009, CLIN NEUROPHYSIOL, V120, P1941, DOI 10.1016/j.clinph.2009.05.030-
hcfmusp.relation.referenceMartino J, 2013, NEUROSURGERY, V72, P87, DOI 10.1227/NEU.0b013e318274294b-
hcfmusp.relation.referenceNieuwenhuys R, 2008, HUMAN CENTRAL NERVOU-
hcfmusp.relation.referencePeltier J, 2010, J NEUROSURG, V112, P1033, DOI 10.3171/2009.6.JNS08132-
hcfmusp.relation.referencePeuskens D, 2004, NEUROSURGERY, V55, P1174, DOI 10.1227/01.NEU.0000140843.62311.24-
hcfmusp.relation.referencePotts MB, 2012, NEUROSURGERY, V70, P824, DOI 10.1227/NEU.0b013e318236760d-
hcfmusp.relation.referenceRhoton AL, 2002, NEUROSURGERY, V51, pS1, DOI 10.1227/01.NEU.0000028086.48597.4F-
hcfmusp.relation.referenceRhoton AL, 2002, NEUROSURGERY, V51, pS207, DOI 10.1227/01.NEU.0000028161.91504.4F-
hcfmusp.relation.referenceRhoton AL, 2002, NEUROSURGERY, V51, pS159, DOI 10.1227/01.NEU.0000028228.51706.2D-
hcfmusp.relation.referenceRibas EC, 2015, J NEUROSURG, V122, P1263, DOI 10.3171/2014.10.JNS141194-
hcfmusp.relation.referenceRibas GC, 2007, ARQ NEURO-PSIQUIAT, V65, P92, DOI 10.1590/S0004-282X2007000100020-
hcfmusp.relation.referenceRibas GC, 2007, REV BRAS PSIQUIATR, V29, P63, DOI 10.1590/S1516-44462007000100017-
hcfmusp.relation.referenceRibas GC, 2010, NEUROSURG FOCUS, V28, DOI 10.3171/2009.11.FOCUS09245-
hcfmusp.relation.referenceSanai N, 2010, J NEUROSURG, V112, P1, DOI 10.3171/2009.6.JNS0952-
hcfmusp.relation.referenceSarubbo S, 2013, BRAIN STRUCT FUNCT, V218, P21, DOI 10.1007/s00429-011-0372-3-
hcfmusp.relation.referenceTanriover N, 2004, J NEUROSURG, V100, P891, DOI 10.3171/jns.2004.100.5.0891-
hcfmusp.relation.referenceTure U, 1999, J NEUROSURG, V90, P720, DOI 10.3171/jns.1999.90.4.0720-
hcfmusp.relation.referenceTure U, 2000, NEUROSURGERY, V47, P417, DOI 10.1097/00006123-200008000-00028-
hcfmusp.relation.referenceTure U, 2000, J NEUROSURG, V92, P676, DOI 10.3171/jns.2000.92.4.0676-
hcfmusp.relation.referenceWang F, 2008, J NEUROSURG, V108, P775, DOI 10.3171/JNS/2008/108/4/0775-
hcfmusp.relation.referenceWen HT, 1998, NEUROSURGERY, V42, P1205, DOI 10.1097/00006123-199806000-00001-
Appears in Collections:

Artigos e Materiais de Revistas Científicas - HC/ICHC
Instituto Central - HC/ICHC

Artigos e Materiais de Revistas Científicas - LIM/02
LIM/02 - Laboratório de Anatomia Médico-Cirúrgica

Files in This Item:
File Description SizeFormat 
  Restricted Access
publishedVersion (English)17.5 MBAdobe PDFView/Open Request a copy

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.