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神经回路:结构与功能——纤维剖析研究。

Neural Circuitry: Architecture and Function-A Fiber Dissection Study.

机构信息

Department of Neurosurgery, K.E.M. Hospital and Seth G.S. Medical College, Parel, Mumbai, India.

Charing Cross Hospital, London, United Kingdom.

出版信息

World Neurosurg. 2019 May;125:e620-e638. doi: 10.1016/j.wneu.2019.01.139. Epub 2019 Feb 2.

Abstract

OBJECTIVE

White fiber dissection using a gyrus-based approach was performed to study the various associations, commissural, and projection fiber bundles of the brain.

METHODS

Ten previously frozen and formalin-fixed cadaveric human brains were included. The fiber dissection techniques described by Klingler were used. The primary dissection tools were thin handmade wooden spatulas and curved metallic spatulas with tips of various sizes. The fibers were studied by the naked eye and with the use of magnification. The various fiber bundles were studied using a gyrus-based approach. The dissection was performed through each named gyrus, and the fiber tracts encountered during dissection were identified, and their relationship to other adjacent fiber bundles was studied.

RESULTS

From our dissections, the white fibers of the brain were divided architecturally into 5 groups-4 horizontal groups and 1 vertical group. The 4 horizontal groups were the superficial, middle, deep, and central groups. The association fibers constituted the superficial, middle, and deep groups. The commissural fibers formed the central group, and the projection fibers formed the vertical group. The course of the fiber bundles and their functional co-relationship were determined.

CONCLUSIONS

When planning the surgical trajectory, knowledge of the location of white matter tracts is essential to help minimize the occurrence of postoperative deficits. Fiber dissection using the Klingler technique is useful in gaining an understanding of the complex 3-dimensional nature of these white matter tracts and can provide a valuable resource in neurosurgical training.

摘要

目的

采用基于脑回的方法进行白质纤维解剖,以研究大脑的各种联合、连合和投射纤维束。

方法

纳入 10 例先前冷冻和福尔马林固定的尸检人脑。使用 Klingler 描述的纤维解剖技术。主要的解剖工具是薄的手工木制刮刀和带有各种尺寸尖端的弯曲金属刮刀。使用肉眼和放大倍数研究纤维。采用基于脑回的方法研究各种纤维束。通过每个命名的脑回进行解剖,识别遇到的纤维束,并研究它们与其他相邻纤维束的关系。

结果

从我们的解剖中,大脑的白质纤维在结构上分为 5 组 - 4 个水平组和 1 个垂直组。4 个水平组是浅、中、深和中央组。联络纤维构成浅、中、深组。连合纤维形成中央组,投射纤维形成垂直组。确定了纤维束的走行及其功能协同关系。

结论

在规划手术轨迹时,了解白质束的位置对于帮助最小化术后缺陷的发生至关重要。使用 Klingler 技术进行纤维解剖有助于了解这些白质束的复杂三维性质,并可为神经外科培训提供有价值的资源。

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