Division of Neurosurgery, Department of Neurosciences, Policlinico "G. Rodolico", University Hospital, Catania, Italy; Neurosurgical Unit, Department of Neuroscience, University of Turin, Turin, Italy.
Neurosurgical Unit, Department of Neuroscience, University of Turin, Turin, Italy.
J Clin Neurosci. 2019 Oct;68:290-294. doi: 10.1016/j.jocn.2019.07.039. Epub 2019 Jul 19.
The Inferior Fronto-Occipital fascicle (IFOF) is a multitasking white matter (WM) bundle bridging frontal, temporal, parietal and occipital lobe. Many papers describe its role in the physiology of language, attention and affective behavior but its anatomical components and cortical terminations remain unclear. We analyze the surgical anatomy of the IFOF in the light of our experience with awake surgery, anatomical dissection on 10 human adult hemispheres (Klingler method) and literature review. Dissecting the specimens from lateral to medial we can describe 3 segments: a vertical segment that runs along the frontal lobe; an horizontal segment that runs along frontal lobe; an horizontal segment that runs from the limen insulae, passes into to the temporal stem and arrives at the parietal and occipital lobes. We retrospectively analyzed also 23 awake surgeries. 2 responses were elicited at subcortical stimulation at the third segment of the IFOF; stimulation gave paraphasias on the first segment of the IFOF in one case. All IFOF responses were founded in the left hemisphere. Anatomical knowledge is the cornerstone of surgical orientation, it allows eloquent structures to be reached quickly and it is of primary importance in awake surgery to avoid patient fatigue with lack of concentration.
下额枕束（IFOF）是一个多任务的白质（WM）束，连接额叶、颞叶、顶叶和枕叶。许多论文描述了它在语言、注意力和情感行为生理学中的作用，但它的解剖成分和皮质末端仍然不清楚。我们根据我们的清醒手术经验、10 个人类成人半球的解剖学解剖（Klingler 方法）和文献复习来分析 IFOF 的手术解剖学。从外侧到内侧解剖标本，我们可以描述 3 个节段：一个垂直节段沿着额叶运行；一个水平节段沿着额叶运行；一个水平节段从岛阈开始，进入颞干，到达顶叶和枕叶。我们还回顾性分析了 23 例清醒手术。在 IFOF 的第三段进行皮质下刺激时，引发了 2 个反应；在一个病例中，刺激在 IFOF 的第一段产生了错语。所有的 IFOF 反应都在左半球中发现。解剖学知识是手术定位的基石，它可以快速到达语言结构，在清醒手术中避免因注意力不集中而导致患者疲劳是非常重要的。
