Morphological Classification of the Medial Frontal Cortex Based on Cadaver Dissections: A Guide for Interhemispheric Approach

• IMADA Yasutaka

  Department of Neurosurgery, Yamada Memorial Hospital

• TAKUMI Toru

  Department of Integrative Bioscience, Graduate School of Biomedical and Health Sciences, Hiroshima University Department of Physiology and Cell Biology, Kobe University School of Medicine

• AOYAMA Hirohiko

  Department of Anatomy and Developmental Biology, Graduate School of Biomedical and Health Sciences, Hiroshima University Faculty of Health Science, Hiroshima International University

• SADATOMO Takashi

  Department of Neurosurgery, Higashihiroshima Medical Center

• KURISU Kaoru

  Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University Department of Neurosurgery, Chugoku-Rosai Hospital

Abstract

The medial frontal cortex (MFC) is a part of the medial surface of the frontal lobe situated in the rostral portion of the corpus callosum (CC). In a surgical interhemispheric approach (IHA), the MFC covers the anterior communicating artery (Aco) complex until the final stage of dissection. To clarify the anatomical relationship between the MFC and the Aco complex, and to facilitate orientation in IHA, we analyzed the morphological features of the MFC in number, size, and pattern of gyri from the medial surface of the hemisphere in the subcallosal portion using 53 adult cadaveric hemispheres. The mean width of the MFC excluding cingulate gyrus (MFCexcg) was 20.6 ± as mm in the subcallosal portion. MFCexcg consisting of 2, 3, 4, or 5 gyri were observed in 7.5%, 56.6%, 32.1%, or 3.8% of the hemispheres, respectively. Bilateral MFCexcg consisting of >2 gyri were observed in approximately 85% of the hemispheres. Therefore, in many cases, the dissection performed at 2 cm upward from the base of the straight gyrus (SG) or 3–4 gyri of the MFC is sufficient to safely reach the upper portion of the cistern of lamina terminalis located distal to the Aco complex in IHA. The MFC is a good landmark for intraoperative orientation in IHA.

Journal

• Neurologia medico-chirurgica

  Neurologia medico-chirurgica 61 (5), 302-311, 2021

  The Japan Neurosurgical Society

Keywords

• medial frontal cortex
• cingulate gyrus
• interhemispheric fissure
• interhemispheric approach
• basal interhemispheric approach

Details

• CRID: 1390851010457189888
• NII Article ID: 130008038533
• DOI: 10.2176/nmc.oa.2020-0192
• ISSN: 13498029
• ISSN: 04708105
• PubMed: 33854001
• Web Site: https://www.jstage.jst.go.jp/article/nmc/61/5/61_oa.2020-0192/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2022000733
• Text Lang: en
• Data Source:
  • JaLC
  • Crossref
  • PubMed
  • CiNii Articles
  • KAKEN
• Abstract License Flag: Disallowed