Neuroanatomical aspects of the temporo–parieto–occipital junction and new surgical strategy to preserve the associated tracts in junctional lesion surgery: fiber separation technique

Abstract

AIM: To describe the location of each white matter pathways around the temporo-parieto-occipital junction (TPOJ) and the dissections performed using focal fiber dissection and fiber separation techniques (FST). These areas play an important role in human language processing and high-level brain functions. Thus, it is important to identify the association of the fascicles as well as their courses to plan safe and effective surgical target vectors. MATERIAL and METHODS: Thirty formalin-fixed human hemispheres and two formalin-fixed human heads were dissected with focal fiber dissection and FST under 6-40× magnification using a surgical microscope and real-time magnetic resonance imaging navigation system. Two-and three-dimensional anatomical and surgical pictures were obtained and processed using high dynamic range photography (Photomatix) and were correlated to radiological images of the case with glioblastoma of the TPOJ. RESULTS: The trajectory and connectivity of these fibers as well as their surgical importance in performing FST in cadaver dissections were demonstrated with correlation of the surgical, radiological, and anatomical images. CONCLUSION: The microanatomy of the TPOJ and related structures, emphasizing the position of each white matter pathway, has been described. Understanding the composition of each region is critical in preventing intraoperative brain injury that could lead to functional deficits.

Importance of Different Characteristic of the Corticospinal Tract Based on DTI and Cadaveric Microdissection

“…Abbreviations: AC, anterior commissure; CS, central sulcus; CST, corticospinal tract; GP, globus pallidus; IFOF, inferior frontooccipital fascicle; ILF, inferior longitudinal fascicle; UF, uncinate fascicle using animal brains (8-12). On the other hand, DTI allows visualisation of this tract in humans in-vivo (28). After originating from the cortex, CST then come together as compact bundles to travel through the internal capsule and cerebral peduncles (29,30).…”

Perceptual Deviations as the Gate to the Workspace Environment and Completeness Extension

“…The MTL-mPFC system, including functionally surrounded important centers (IFG, FEF, TPJ and other), are critical in encoding and executing the information during rivalry processing, and it could be the first candidate of a system operating at the perception-recognition selection stage, responsible for novelty checking and propagate back informational influences to early perceptional system. The TPO is likely candidate to resolve early perceptual information, regarding of its anatomo-functional position (De Benedictis et al, 2014;Biceroglu & Karadağ, 2019). Aside, it also might be involving in a process of multimodal exchanges between attentional, perceptional and cognitive functions.…”