Maldonado Igor Lima, Destrieux Christophe, Ribas Eduardo Carvalhal, Siqueira de Abreu Brito Guimarães Bruna, Cruz Patrícia Pontes, Duffau Hugues
1UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.
2CHRU de Tours, France.
J Neurosurg. 2021 Jan 8;135(4):1214-1222. doi: 10.3171/2020.7.JNS192846. Print 2021 Oct 1.
The sagittal stratum is divided into two layers. In classic descriptions, the stratum sagittale internum corresponds to optic radiations (RADs), whereas the stratum sagittale externum corresponds to fibers of the inferior longitudinal fasciculus. Although advanced for the time it was proposed, this schematic organization seems simplistic considering the recent progress on the understanding of cerebral connectivity and needs to be updated. Therefore, the authors sought to investigate the composition of the sagittal stratum and to detail the anatomical relationships among the macroscopic fasciculi.
The authors performed a layer-by-layer fiber dissection from the superolateral aspect to the ventricular cavity in 20 cadaveric human hemispheres.
Diverse bundles of white matter were observed to contribute to the sagittal stratum and their spatial arrangement was highly consistent from one individual to another. This was the case of the middle longitudinal fasciculus, the inferior fronto-occipital fasciculus, the RADs, and other posterior thalamic radiations directed to nonvisual areas of the cerebral cortex. In addition, small contributions to the sagittal stratum came from the anterior commissure anteriorly and the inferior longitudinal fasciculus inferiorly.
A general model of sagittal stratum organization in layers is possible, but the composition of the external layer is much more complex than is mentioned in classic descriptions. A small contribution of the inferior longitudinal fasciculus is the main difference between the present results and the classic descriptions in which this bundle was considered to entirely correspond to the stratum sagittale externum. This subject has important implications both for fundamental research and neurosurgery, as well as for the development of surgical approaches for the cerebral parenchyma and ventricular system.
矢状层分为两层。在经典描述中,矢状内层对应视辐射(RADs),而矢状外层对应下纵束的纤维。尽管在其提出之时这一模式具有先进性,但考虑到近期在脑连接性理解方面的进展,这种示意性组织似乎过于简单,需要更新。因此,作者试图研究矢状层的组成,并详细阐述宏观束之间的解剖关系。
作者对20个尸体人类半球从超外侧面向脑室腔进行逐层纤维解剖。
观察到多种白质束构成矢状层,且它们的空间排列在个体间高度一致。中间纵束、额枕下束、视辐射以及其他指向大脑皮质非视觉区域的丘脑后辐射均是如此。此外,矢状层前部有来自前连合的少量纤维贡献,下部有来自下纵束的少量纤维贡献。
矢状层分层组织的通用模型是可行的,但外层的组成比经典描述中提到的要复杂得多。下纵束的少量贡献是本研究结果与经典描述的主要差异,在经典描述中该束被认为完全对应矢状外层。这一主题对基础研究和神经外科手术以及脑实质和脑室系统手术入路的发展都具有重要意义。