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Normal Cortical Anatomy MGH Massachusetts General Hospital Harvard Medical School.

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Presentation on theme: "Normal Cortical Anatomy MGH Massachusetts General Hospital Harvard Medical School."— Presentation transcript:

1 Normal Cortical Anatomy MGH Massachusetts General Hospital Harvard Medical School

2 NP/MGH NORMAL CORTICAL ANATOMY SagittalSagittal AxialAxial CoronalCoronal The Central SulcusThe Central Sulcus

3 NP/MGH Sagittal Neuroanatomy

4 NP/MGH Subcallosal gyrus Gyrus rectus Parietooccipital sulcus Fastigium, fourth ventricle Cingulate gyrus Calcarine sulcus Marginal ramus of Cingulate sulcus Superior parietal lobule Paracentral lobule Cingulate sulcus Superior frontal gyrus Cuneus Lingual gyrus

5 NP/MGH Gyrus rectus Parietooccipital sulcus Cingulate gyrus Calcarine sulcus Lingual gyrus Marginal ramus of Cingulate sulcus Superior parietal lobule Cingulate sulcus Caudothallamic groove Precuneus Central sulcus Cuneus Precentral gyrus Frontomarginal gyrus Superior frontal gyrus

6 NP/MGH Parietooccipital sulcus Calcarine sulcus Superior parietal lobule Marginal ramus of Cingulate sulcus Central sulcus Precentral sulcus Precuneus Corona radiata Superior frontal gyrus Lingual gyrus Inferior occipital gyrus

7 NP/MGH Inferior temporal gyrus Temporal horn, lateral ventricle Central sulcus Posterior orbital gyrus Frontomarginal gyrus Medial orbital gyrus Frontopolar gyrus Parietooccipital sulcus Lingual gyrus Inferior occipital gyrus Superior occipital gyrus Middle occipital gyrus Superior parietal lobule

8 NP/MGH Central sulcus Inferior Temporal gyrus Middle Temporal gyrus Superior Temporal gyrus

9 NP/MGH Central sulcus Lingual gyrus Inferior occipital gyrus Superior parietal gyrus Middle occipital gyrus Superior occipital gyrus Inferior Temporal gyrus Middle Temporal gyrus Superior Temporal gyrus Posterior orbital gyrus Anterior orbital gyrus Frontomarginal gyrus Inferior frontal gyrus

10 NP/MGH Inferior Temporal gyrus Superior Temporal sulcus Superior Temporal gyrus Anterior occipital sulcus Superior frontal sulcus Precentral sulcus Central sulcus Postcentral sulcus Angular gyrus Lateral fissure, posterior segment Inferior frontal gyrus, pars orbitalis Middle Temporal gyrus Inferior occipital gyrus Middle occipital gyrus Inferior frontal gyrus, pars triangularis

11 NP/MGH Axial Neuroanatomy

12 NP/MGH Superior Temporal gyrus Middle Temporal gyrus Inferior Temporal gyrus Fusiform gyrus

13 NP/MGH Superior Temporal gyrus Middle Temporal gyrus Inferior Temporal gyrus Parahippocampal gyrus Hippocampal gyrus

14 NP/MGH Temporo-occipital fissure Inferior occipital gyrus Lingual gyrus Gyrus descendens Superior Temporal gyrus Middle Temporal gyrus Inferior Temporal gyrus AmygdalaHippocampus

15 NP/MGH Gyrus rectus Olfactory sulcus Medial orbital gyrus Subcallosal gyrus Posterior orbital gyrus Temporo-occipital fissure Middle occipital gyrus Lingual gyrus Amygdala Hippocampus Superior Temporal gyrus Middle Temporal gyrus Inferior Temporal gyrus Gyrus descendens

16 NP/MGH Superior Temporal gyrus Middle Temporal gyrus Gyrus rectus Olfactory sulcusMedial orbital gyrus Anterior orbital gyrus Posterior orbital gyrus Lingual gyrus Parahippocampal gyrus Calcarine sulcus CuneusGyrus descendens Temporo-occipital fissure Middle occipital gyrus Intra-occipital sulcus

17 NP/MGH Superior frontal gyrus Anterior orbital gyrus Posterior orbital gyrus Frontomarginal gyrus Cingulate gyrus Superior occipital gyrusIntra-occipital sulcus Middle occipital gyrus

18 NP/MGH Superior occipital gyrus Intra-occipital sulcus Middle occipital gyrus Cingulate gyrus Parieto-occipital fissure Calcarine sulcus Cuneus Middle temporal gyrus Superior temporal sulcus Superior temporal gyrus Insula Inferior frontal gyrus, pars orbitalis Superior frontal gyrusMiddle frontal gyrus Inferior frontal gyrus, pars opercularis Lateral fissure Inferior parietal gyrus

19 NP/MGH Middle occipital gyrus Superior temporal gyrus Intra-occipital sulcus Superior frontal gyrus Central sulcus Superior occipital gyrus Parieto-occipital sulcus Superior temporal sulcus Lateral fissure Inferior parietal gyrus Postcentral gyrus Lateral fissure Middle frontal gyrus Inferior frontal gyrus

20 NP/MGH Superior occipital gyrus Cuneus Intra-occipital sulcus Middle occipital gyrus Central sulcus Precentral sulcus Precentral gyrus Central sulcus

21 NP/MGH Postcentral sulcus Superior frontal sulcus Central sulcus Intraparietal sulcus Superior frontal gyrus Middle frontal gyrus Superior parietal gyrus Centrum semiovale Parietooccipital sulcus Precuneus Angular gyrus Central sulcus Inferior frontal gyrus Supramarginal gyrus Postcentral sulcus

22 NP/MGH Postcentral sulcus Central sulcus Superior frontal sulcus Pars marginalis Intraparietal sulcus Superior frontal gyrus Middle frontal gyrus Superior parietal gyrus Angular gyrus Supramarginal gyrus Intraparietal sulcus Central sulcus

23 NP/MGH Central sulcus Postcentral sulcus Superior frontal sulcus Precentral sulcus Pars marginalis Intraparietal sulcus Superior frontal gyrus Middle frontal gyrus Superior parietal gyrus Angular gyrus Postcentral gyrus Supramarginal gyrus Precentral gyrus

24 NP/MGH Central sulcus Postcentral sulcus Superior frontal sulcus Precentral sulcus Pars marginalis Intraparietal sulcus Superior frontal gyrus Middle frontal gyrus Precuneus Paracentral lobule Superior parietal gyrus

25 NP/MGH Coronal Neuroanatomy

26 NP/MGH Olfactory bulb Gyrus rectus Medial Orbital gyrus Inferior Frontal gyrus Superior Frontal gyrus Middle Frontal gyrus Interhemispheric Fissure Inferior Frontal gyrus

27 NP/MGH Forceps minor Olfactory Sulcus Lateral orbital gyrus Inferior Frontal gyrus Superior Frontal gyrus Superior Frontal sulcus Middle Frontal gyrus Medial Orbital gyrus Gyrus rectus Anterior Orbital gyrus Lateral orbital sulcus

28 NP/MGH Inferior Frontal gyrus pars opercularis Superior Frontal gyrus Middle Frontal gyrus Sylvian Fissure Posterior Orbital gyrus Inferior Temporal gyrus Cingulate gyrusCircular insular sulcus Olfactory Sulcus Superior Temporal gyrus Middle Temporal gyrus Inferior Frontal sulcusshort insular gyrus Gyrus rectus Medial Orbital gyrus

29 NP/MGH Superior Frontal gyrus Superior Frontal sulcus Middle Frontal gyrus Superior Temporal Sulcus Sylvian Fissure Amygdala Precentral sulcus Anterior commissure Cingulate sulcus Superior Temporal gyrus Middle Temporal gyrus Inferior Temporal gyrus Precentral gyrus

30 NP/MGH Superior Frontal gyrus Middle Frontal gyrus Superior Temporal gyrus Middle Temporal gyrus Superior Temporal Sulcus Sylvian Fissure Heschl’s gyrus Inferior Temporal sulcus Inferior Temporal gyrusAmygdala Ambient gyrus Entorhinal area Cingulate gyrus Superior Frontal sulcus Precentral sulcus Precentral gyrus

31 NP/MGH Superior Frontal gyrus Middle Frontal gyrus Superior Temporal gyrus Middle Temporal gyrus Inferior Temporal gyrus Fusiform gyrus Hippocampus CA1, cornu ammonisParahippocampal gyrus Central Sulcus

32 NP/MGH Paracentral lobule Superior Temporal gyrus Middle Temporal gyrus Inferior Temporal gyrus Central Sulcus Postcentral gyrus Cingulate gyrus Intraparietal sulcus Fusiform gyrus Collateral sulcus Parahippocampal gyrus Supramarginal gyrus Intraparietal sulcus

33 NP/MGH Superior Temporal gyrus Middle Temporal gyrus Inferior temporal gyrus Fusiform gyrus Central sulcus Paracentral lobule

34 NP/MGH Fusiform gyrus Lingual gyrus Calcarine sulcusCingulate gyrus Inferior temporal gyrus Middle temporal gyrus Supramarginal gyrus Intraparietal sulcus Central sulcus Paracentral lobule Postcentral gyrus

35 NP/MGH Lingual gyrus Calcarine sulcus Superior parietal lobule precuneus Cingulate gyrus Tentorium cerebelli Fusiform gyrus Inferior parietal lobule Middle occipital gyrus Inferior occipital gyrus Lingual gyrus Collateral sulcus

36 NP/MGH The Central Sulcus

37 NP/MGH superior frontal sulcus - pre CS sign sigmoidal Hook sign pars bracket sign Bifid post-CS sign thin postcentral gyrus sign intraparital sulcus - post-CS midline sulcus sign The Central Sulcus (CS)* *Naidich & Brightbill. Int J Neurorad 1996;2:

38 NP/MGH Superior frontal sulcus - preCS sign – –the posterior end of the superior frontal sulcus joins the precentral sulcus in 85% The Central Sulcus (CS) Precentral sulcus Superior frontal sulcus Precentral gyrusCentral sulcus Superior frontal gyrus Superior frontal sulcus Precentral sulcus Precentral gyrus

39 NP/MGH Sigmoid “Hook” –hooklike configuration of the posterior surface of the precentral gyrus –the “hook” corresponds to the motor hand area. –The “hook” is well seen on CT (89%) and MRI (98%). The Central Sulcus (CS) Precentral sulcus Central sulcus

40 NP/MGH pars bracket sign – –The paired pars marginalis form a “bracket” to each side of the interhemispheric fissure at or behind the central sulcus (96%). The Central Sulcus (CS) Precentral sulcus Superior frontal sulcus Precentral gyrus Central sulcus Pars bracketParacentral lobule

41 NP/MGH pars bracket sign The Central Sulcus (CS) Precentral sulcus Superior frontal sulcus Precentral gyrus Central sulcus Pars bracket

42 NP/MGH Bifid post-CS sign – –the post-CS is bifid (85%). – –The bifid post-CS encloses the lateral end of the pars marginalis (88%). The Central Sulcus (CS) Precentral sulcus Precentral gyrus Central sulcus Postcentral sulcus Pars bracket

43 NP/MGH Central sulcus Postcentral sulcus Central sulcus Postcentral sulcus Pars bracket

44 NP/MGH Thin post-CG sign –the postcentral gyrus is thinner than the precentral gyrus (98%). The Central Sulcus (CS) Precentral gyrus Postcentral gyrus

45 NP/MGH Intraparietal Sulcus (IPS) and the post-CS –in axial MRI, the IPS intersects the post-CS (99%). The Central Sulcus (CS) Pars bracket IPS Postcentral sulcus IPS Pars bracket

46 NP/MGH Postcentral sulcus IPS Postcentral sulcus IPS Postcentral sulcus IPS

47 NP/MGH Precentral sulcus Superior frontal sulcus Precentral gyrus Central sulcus Superior frontal gyrus Midline Sulcus sign –the most prominent convexity sulcus that reaches the midline interhemispheric fissure is the CS (70%). The Central Sulcus (CS)

48 NP/MGH The Central Sulcus (CS)

49 NP/MGH SFS-preCS sign Hook sign Pars bracket sign Bifid post-CS sign Thin postcentral gyrus sign IPS - postCS sign The Central Sulcus (CS)


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