Cadaveric White Matter Dissection Study of the Telencephalic Flexure: Surgical Implications.
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State: Public
Version: author
License: CC BY 4.0
UNIL restricted access
State: Public
Version: author
License: CC BY 4.0
Serval ID
serval:BIB_A0C7D2C5534D
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Cadaveric White Matter Dissection Study of the Telencephalic Flexure: Surgical Implications.
Journal
Frontiers in neurology
ISSN
1664-2295 (Print)
ISSN-L
1664-2295
Publication state
Published
Issued date
2022
Peer-reviewed
Oui
Volume
13
Pages
757757
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Publication Status: epublish
Abstract
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.
Keywords
brain surgery, disconnective surgery, epilepsy surgery, functional connectome, oncology, sylvian fissure, telencephalic flexure
Pubmed
Web of science
Open Access
Yes
Create date
14/03/2022 9:02
Last modification date
31/12/2022 6:50