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Three dimensional anatomy of the white matter fibers of the temporal lobe: Surgical implications.
World Neurosurg. 2017 Jan 05;:
Authors: Pescatori L, Tropeano MP, Manfreda A, Delfini R, Santoro A
Abstract
BACKGROUND: The aim of this work is to describe in detail the complex three-dimensional organization of the white matter of the temporal lobe and discuss the surgical implications of the approaches to lesions located into the mesial temporal region and within the temporal horn and the atrium of the lateral ventricles.
METHODS: Sixteen human cerebral hemispheres fixed in a 10% formalin solution for at least 40 days were studied. After removal of the arachnoid membrane, the hemispheres were frozen at -15 C° for at least 15 days , and the Klingler' technique which consist in the microscopic dissection and progressive identification of white matter fibers was performed.
RESULTS: The dissection allow us to appreciate the topographical organization of the white matter of the temporal lobe identifying the most important association, projection, and commissural fasciculi. The dissection from the lateral side allowed the progressive visualization of the superior longitudinal fasciculus and its components, the extreme and external capsule, the uncinate fasciculus, the inferior fronto-occipital fasciculus, the anterior commissure, the internal capsule and the optic radiations. The dissection was completed from the inferior and medial side for identification of the cingulum and the fornix.
CONCLUSIONS: The complex three dimensional organization of the white matter substance of the temporal lobe is characterized by two main system of boundless: the sagittal stratum and the temporal stem. Their knowledge is essential for the appropriate treatment of pathologies localized in this region as demonstrated by the two clinical cases presented in this work.
PMID: 28065876 [PubMed - as supplied by publisher]
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