Choi Chan-Young, Han Seong-Rok, Yee Gi-Taek, Lee Chae-Heuck
Department of Neurological Surgery, Ilsan Paik Hospital, College of Medicine, Inje University, Goyang, Korea.
J Korean Neurosurg Soc. 2010 May;47(5):365-9. doi: 10.3340/jkns.2010.47.5.365. Epub 2010 May 31.
There has been inconsistency about definition of the temporal stem despite of several descriptions demonstrating its microanatomy using fiber dissection and/or diffusion tensor tractography. This study was designed to clarify three dimensional configurations of the temporal stem.
The fronto-temporal regions of several formalin-fixed human cerebral hemispheres were dissected under an operating microscope using the fiber dissection technique. The consecutive coronal cuts of the dissected specimens were made to define the relationships of white matter tracts comprising the temporal stem and the subcortical gray matters (thalamus, caudate nucleus, amygdala) with inferior limiting (circular) sulcus of insula.
The inferior limiting sulcus of insula, limen insulae, medial sylvian groove, and caudate nucleus/amygdala were more appropriate anatomical structures than the roof/dorso-lateral wall of the temporal horn and lateral geniculate body which were used to describe previously for delineating the temporal stem. The particular space located inside the line connecting the inferior limiting sulcus of insula, limen insulae, medial sylvian groove/amygdala, and tail of caudate nucleus could be documented. This space included the extreme capsule, uncinate fasciculus, inferior occipito-frontal fasciculus, anterior commissure, ansa peduncularis, and inferior thalamic peduncle including optic radiations, whereas the stria terminalis, cingulum, fimbria, and inferior longitudinal fiber of the temporal lobe were not passing through this space. Also, this continued posteriorly along the caudate nucleus and limiting sulcus of the insula.
The temporal stem is white matter fibers passing through a particular space of the temporal lobe located inside the line connecting the inferior limiting sulcus of insula, limen insulae, medial sylvian groove/amygdala, and tail of caudate nucleus. The three dimensional configurations of the temporal stem are expected to give the very useful anatomical and surgical insights in the temporal lobe.
尽管有多项研究利用纤维解剖和/或扩散张量纤维束成像展示了颞干的微观解剖结构，但其定义仍存在不一致之处。本研究旨在阐明颞干的三维结构。
在手术显微镜下，使用纤维解剖技术对多个福尔马林固定的人类大脑半球的额颞区域进行解剖。对解剖后的标本进行连续冠状切片，以确定构成颞干的白质束与岛叶下极限（环状）沟、皮质下灰质（丘脑、尾状核、杏仁核）之间的关系。
与先前用于描述颞干的颞角顶壁/背侧壁和外侧膝状体相比，岛叶下极限沟、岛阈、大脑外侧沟内侧和尾状核/杏仁核是更合适的解剖结构。可以记录位于连接岛叶下极限沟、岛阈、大脑外侧沟内侧/杏仁核和尾状核尾部的线内的特定空间。这个空间包括外囊、钩束、枕额下束、前连合、脚间袢以及包括视辐射在内的丘脑下脚，而终纹、扣带、伞和颞叶的下纵纤维不穿过这个空间。此外，它沿着尾状核和岛叶的极限沟向后延续。
颞干是穿过颞叶特定空间的白质纤维，该空间位于连接岛叶下极限沟、岛阈、大脑外侧沟内侧/杏仁核和尾状核尾部的线内。颞干的三维结构有望为颞叶提供非常有用的解剖学和手术学见解。
