Computed tomographic localization of the central sulcus: a morphometric study in adult patients

Oberman, Dan Zimelewicz; Rasmussen, Jorge; Toscano, Maximiliano; Goldschmidt, Ezequiel; Ajler, Pablo

doi:10.5137/1019-5149.jtn.21145-17.1

Cited by 4 publications

(2 citation statements)

References 12 publications

(16 reference statements)

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“…Thus, an easier skin landmark might be useful for identification of this major sulci of the brain. In this study, the mean distance between nasion and OSP of the SRoP was 190.7 ± 4.5 mm which is consistent with world literature [15]. Rhoton described an angle of 70° between midline and mean orientation of the central sulcus, which is comparable but higher than our results (56.79° ± 8°) [17].…”

Section: Central Sulcussupporting

confidence: 92%

“…Rhoton described an angle of 70° between midline and mean orientation of the central sulcus, which is comparable but higher than our results (56.79° ± 8°) [17]. To the best of our knowledge, SPCP has never been precisely named in any anatomical study, but its localization is consistent with previous studies describing de pre-central sulcus [15].…”

Section: Central Sulcussupporting

confidence: 88%

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Skin landmarks to main cerebral structures: how to identify the main cerebral sulci? An anatomical study

et al. 2021

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Purpose Neuronavigation is used in neurosurgical practice to locate the cortical structures. If this tool is unavailable, basic anatomical knowledge should be used. Craniometry has been rarely detailed in recent literature, systematically using bony landmarks. The aim of this study is to describe skin landmarks for neurosurgical practice. Methods Dissection of 10 hemispheres with insertion of radio-opaque markers within the limits of lateral sulcus, central and pre-central sulci, and preoccipital notch. Computed tomography was performed in all cases and multiplanar reconstructions were performed. Maximal intensity projection (MIP) fusion images were used for measurements between known skin landmarks and sulci of interests. ResultsThe Anterior Sylvian Point is measured 31.8 ± 2.8 mm behind the orbital wall, 36.9 ± 3 mm above the zygomatic arch. The horizontal part of the lateral sulcus is measured 59 ± 6 mm above the tragus. The Superior Rolandic Point is measured 190.7 ± 4.5 mm behind the nasion. The Pre-occipital Notch is measured 37.0 ± 6.9 mm above the tragus and 67.1 ± 6.4 mm behind. The Ideal Entry Points (IEP) for ventricular punctures are measured 120.2 ± 7 mm behind the nasion and 33.8 ± 3 mm laterally for the frontal IEP, and 61.3 mm ± 2.5 mm above and 64.7 ± 6.8 mm behind the tragus for the parieto-occipital IEP. ConclusionIn this study, we described simple skin landmarks for lateral sulcus, central sulcus, preoccipital notch, and an IEP for ventricular drainage. Precise knowledge of brain sulcal anatomy will guide patient's positioning, skin incision, and craniotomies; and permits checking of imaging data provided by neuronavigation systems.

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Section: Central Sulcussupporting

confidence: 92%

Section: Central Sulcussupporting

confidence: 88%

Skin landmarks to main cerebral structures: how to identify the main cerebral sulci? An anatomical study

et al. 2021

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Skin landmarks to main cerebral structures: how to identify the main cerebral sulci? A radiological study about lateral, central, and parietooccipital sulci

et al. 2022

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Surgical Technique and Outcome of Extensive Frontal Lobectomy for Treatment of Intracable Non-lesional Frontal Lobe Epilepsy

Hirata

Morino

Nakae

et al. 2020

Neurol. Med. Chir.(Tokyo)

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Although extensive frontal lobectomy (eFL) is a common surgical procedure for intractable frontal lobe epilepsy (FLE), there have been very few reports regarding surgical techniques for eFL. This article provides step-by-step descriptions of our surgical technique for non-lesional FLE. Sixteen patients undergoing eFL were included in this study. The goals were to maximize gray matter removal, including the orbital gyrus and subcallosal area, and to spare the primary motor and premotor cortexes and anterior perforated substance. The eFL consists of three steps: (1) positioning, craniotomy, and exposure; (2) lateral frontal lobe resection; and (3), resection of the rectus gyrus and orbital gyrus. Resection ahead of bregma allows preservation of motor and premotor area function. To remove the orbital gyrus preserving anterior perforated substance, it is essential to visualize the olfactory trigone beneath the pia. It is important to observe the surface of the contralateral medial frontal lobe for complete removal of the subcallosal area of the frontal lobe. Thirteen patients (81.25%) became seizure-free and three patients (18.75%) continued to have seizures. None of the patients showed any complications. The eFL is a good surgical technique for the treatment of intractable non-lesional FLE. For treatment of epilepsy by eFL, it is important to resect the non-eloquent area of the frontal lobe as much as possible with preservation of the eloquent cortex.

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Computed tomographic localization of the central sulcus: a morphometric study in adult patients

Abstract: The central sulcus was located accurately, on average 47.8 mm behind the bregma, which should be used instead of nasion in order to avoid gender discrepancy. The data obtained provide useful and reliable information to guide neurosurgical procedures.

Cited by 4 publications

References 12 publications

Skin landmarks to main cerebral structures: how to identify the main cerebral sulci? An anatomical study

Skin landmarks to main cerebral structures: how to identify the main cerebral sulci? An anatomical study

Skin landmarks to main cerebral structures: how to identify the main cerebral sulci? A radiological study about lateral, central, and parietooccipital sulci

Surgical Technique and Outcome of Extensive Frontal Lobectomy for Treatment of Intracable Non-lesional Frontal Lobe Epilepsy

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