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Radiological Anatomy

of the
Brain
Prof Dr Mahmoud El Sheikh
Lecturer Abdel Aziz El Neikedy
Ass Lecturer Mohamed Samir
Radiology Department
Faculty of Medicine. University of Alexandria
Objectives
• Demonstration the radiological anatomy of the
different parts of the brain.
• Identification of different parts of the brain using
the imaging modalities.
• Differentiation between different modalities
used to image the brain.
The medical imaging modalities include:
• Conventional Radiography
• Computed Tomography (CT)
• Magnetic Resonance Imaging (MRI)
• Ultrasonography
• Nuclear Medicine
And Interventional Radiography
Computed Tomography (CT)
Principle of CT
The X-ray The X-rays
tube after
rotates traversing the
around the body are
patient in a picked up by
circle while the detectors
a ring of and are
detectors transmitted to
rotates the a computer
other side chain that
of the reconstructs
patient. digital images.
Normal CT Scan of
the Brain
CT scan of the Brain
Magnetic Resonance (MR)

Magnet

Radio-frequency Coil

Closed Magnet Open Magnet


Principle of Magnetic Resonance

• Protons (nuclei of hydrogen atoms) placed in a


strong magnetic field are excited by a radio-
frequency pulse, then allowed to loose energy.

• The loss of gained energy occurs either to the


surrounding matrix (T1 relaxation) or through
interaction between each other (T2 relaxation).

• The loss of energy (relaxation) is measured and


recorded. The data are sent to a computer to
generate digital images.
Normal MR Brain

T1 Weighted Image T2 Weighted Image


MRI of the Brain
MR Brain

Axial Sagittal Coronal

T1 Weighted Images
Anatomy of The Brain
• Cerebrum.
• Cerebellum.
• Brain Stem.
• Pituitary Gland.
• Dural reflections.
• CSF Spaces.
Cerebrum
Cerebrum

• 2 Hemispheres.
• 4 Lobes
(Frontal, Parietal, Temporal & Occipital).
• Commissures.
Cerebrum
• Lobes
MR
Frontal, Parietal, Temporal & Occipital.

CT
Cerebrum
• Lobes
Frontal, Parietal, Temporal & Occipital.

MR
Cerebrum

Commissures
1- Corpus callosum
(rostrum, genu, body & splenium).
2- Anterior commissure. MR
3- Posterior commissure.
4- Hippocampal commissure.
Cerebrum

Fissures:
• Interhemispheric fissure.
• Sylvian fissure.
• Parieto-occipital fissure.
Cerebrum

Fissures: MR
• Interhemispheric fissure.

CT
Cerebrum

Fissures:
• Interhemispheric fissure. MR

CT
Cerebrum

Fissures:
• Sylvian fissure.
Cerebrum

Fissures:
• Sylvian fissure.

MR CT
Cerebrum

Fissures:
• Sylvian fissure.

MR
CT
Cerebrum

Fissures: MR
• Sylvian fissure.

CT
Cerebrum

Fissures: MR
• Parieto-occipital fissure.
Cerebrum

1. Gray Matter.

2. White Matter.
Cerebrum

Gray Matter:
• Cortex.
• Deep Nuclei.
Cerebrum

Gray Matter Nuclei:


• Basal Ganglia.
• Thalami.
• Hypothalami.
Cerebrum

• Basal Ganglia.
• Caudate nucleus.
• Putamen.
• Globus Pallidus.
• Claustrum.
• Subthalamic Nucleus
Cerebrum

• Caudate nucleus.
Cerebrum

• Caudate nucleus.
Cerebrum

• Caudate nucleus.

MR
CT
Cerebrum

• Putamen & Globus Pallidus.


Cerebrum

• Putamen & Globus Pallidus.


Cerebrum

• Putamen & Globus Pallidus.


Cerebrum

• Claustrum
Cerebrum

• Globus pallidus + Putamen = Lentiform nucleus.

• Caudate + Putamen = Corpus Striatum.


Cerebrum

• Thalamus
Cerebrum

• Thalamus

Thalamus

MR
Cerebrum

• Hypothalamus:

MR
Cerebrum

• Hypothalamus:

• Infundibulum.
• Tuber cinerium.
• Mammillary bodies.

MR
Cerebrum

• Hypothalamus:

MR
CT
Cerebrum
CT
• White Matter.

Internal Capsule Corona Radiata Centrum Semiovale


Cerebrum

• White Matter. MR

Internal Capsule Corona Radiata Centrum Semiovale


Cerebrum

• White Matter.
Internal capsule

External Capsule

Anterior limb

Genu

Posterior limb
Brain Stem
Brain Stem

Brain Stem:
1. Midbrain.
2. Pons.
3. Medulla Oblongata.
Brain Stem

• Midbrain:

Cerebral
Peduncle

Tegmentum

Tectum
Brain Stem MR

• Midbrain:

Interpeduncular fossa

Cerebral peduncle
Substansia
Nigra Red nucleus

Cerebral
Aqueduct Colliculus
Brain Stem MR

• Midbrain.

Colliculi
Brain Stem MR
Sagittal

• Midbrain.
Brain Stem MR
Coronal

• Midbrain.
Brain Stem MR

• Pons.

Basis Pontis
Brain Stem

• Pons.

MR
Brain Stem

• Pons.

MR
Brain Stem

• Pons.

Cerebellar Peduncles:
1. Superior.
2. Middle (Brachium Pontis)
3. Inferior.

MR
Brain Stem

• Medulla Oblongata.
Brain Stem

• Medulla Oblongata.

MR
Brain Stem

• Medulla Oblongata.

MR
Pituitary Gland
Pituitary Gland
Pituitary Gland
Pituitary Gland MR
MR
Pituitary Gland

Optic Chiasm

Infundibulum

Anterior lobe

Posterior lobe
Pituitary Gland
Optic chiasm

MR
Infundibulum

Pituitary Gland.
Pituitary Gland

MR
Optic Chiasm.

Optic Nerve

Optic Chiasm

Optic Tract
Optic Chiasm.

MR
Optic Chiasm.
Optic Tract
Optic Nerve
Optic Chiasm.
MR
Optic Chiasm.

MR Optic Chiasm
Optic Tracts
Optic Nerves
Cerebellum
Cerebellum.

Location.
Cerebellum.

Parts:
• 2 hemispheres:
Anterior lobe.
Posterior lobe.
Floccunodular lobe.
• Vermis.
MR
Cerebellum.

Parts:
• 2 hemispheres: Anterior lobe. Primary Fissure.
Anterior lobe.
Posterior lobe.
Floccunodular lobe.
• Vermis. Floccunodular
lobe

Posterior lobe.
Tonsil
Cerebellum.

Parts:
• 2 hemispheres:
Anterior lobe.
Posterior lobe.
Floccunodular lobe.
• Vermis.
MR
Cerebellum.

Parts:
• 2 hemispheres:
Anterior lobe.
Posterior lobe.
Floccunodular lobe.
• Vermis.
MR
Cerebellum.

Parts:
• 2 hemispheres:
Anterior lobe.
Posterior lobe.
Floccunodular lobe.
• Vermis.
Cerebellum. MR

Cerebellar peduncles:
1. Superior.
2. Middle (Brachium Pontis).
3. Inferior.
Cerebellum.

Dentate Nucleus.
Dural Reflexions
Dural Reflexions.

Meninges.
Dural Reflexions.

Dura Mater.

☺ The outermost layer.


☺ Dura mater is a tough fibrous
layer formed by fusion of:
1. An inner dura mater proper.
2. The periostium of skull bones
that is attached to suture
lines.
….these 2 layers
are tightly fused together
except when they split to
Enclose dural sinuses.
Dural Reflexions.

Dura Mater.

☺ Superficial to dura mater is a


potential space called extra-
dural space, this space is
limited at suture lines.
☺ Deep to the dura another
potential space; the sub-
dural space, it lies between
dura & arachnoid mater.
Dural Reflexions.

Falx Cerebri.
Dural Reflexions.

Falx Cerebri.
Dural Reflexions.

Tentorium.
Dural Reflexions.
MR
Tentorium.
Dural Reflexions.

Diaphragma sellae:
- A dural fold that is stretched
between the
anterior & posterior clinoid
processes.
- It roofs the sella turcica & is
pierced by the
infundibulum of pituitary
gland.
CSF Spaces
CSF Spaces.

1. Ventricular System.

2. Subarachnoid Spaces.
CSF Spaces.

Ventricular System.

Supra-Tentorial.
• 2 Lateral ventricles.
• Third ventricle.
Infra-Tentorial
• Fourth ventricle
CSF Spaces.

Lateral Ventricles.

• Frontal, temporal and occipital horns.


• Body.
• Atrium.
• Foramina of Monro.
CSF Spaces.

Lateral Ventricles.
CSF Spaces. MR

Lateral Ventricles.
CSF Spaces. MR

Lateral Ventricles.
MR
CSF Spaces.

Lateral Ventricles.
CSF Spaces.

Septum Pellucidum.
MR
CSF Spaces.

Foramen of Monro
MR

Fornix
CSF Spaces.

Third Ventricle.
CSF Spaces. MR

Third Ventricle. Fornix

Anterior Commissure Corpus Callosum

Optic Chiasm

Pineal Body
Infundibulum
Lamina Terminalis
Tuber CineriumMidbrain
Mammillary Bodies
CSF Spaces.

Third Ventricle.
Massa Intermedia

Chiasmatic Recess

Infundibular Recess
CSF Spaces.
MR
Third Ventricle.
CSF Spaces.

Aqueduct of Sylvius
MR
CSF Spaces.

Aqueduct of Sylvius
CSF Spaces.

Fourth Ventricle.

Roof:
Cerebellum.

Floor:
Pons.
Upper half of the medulla.
CSF Spaces.

Fourth Ventricle.

Drains into:
• 2 lateral foramina of Luschka.
• Median foramen of Magendi.
• Central Canal of the spinal co.rd
MR
CSF Spaces.

Fourth Ventricle.
CSF Spaces.

Cisterns.

Dilated subarachnoid spaces.


CSF Spaces. MR

Cisterna Magna.
CSF Spaces. MR

Sylvian Cistern.
CSF Spaces.

Quadrigeminal Cistern.

MR
CSF Spaces.

Quadrigeminal Cistern.

MR
CSF Spaces.

Ambient Cistern.

MR
CSF Spaces.

Cerebello-Pontine Angle
Cistern.

MR
CSF Spaces.

Pre-Pontine Angle Cistern. MR


CSF Spaces.

Superior vermian Cistern. MR


CSF Spaces.

Supra-Sellar Cistern.

MR
CSF Spaces.

Interpeduncular Cistern.

MR
CSF Spaces.

Inter-hemispheric Cistern.

MR
Cerebral Vessels
Cerebral Arteries
Left
subclavian
artery
Arterial Vascular Territories

Anterior Cerebral Artery Middle Cerebral Artery Posterior Cerebral Artery


Internal Carotid Artery

Anterior and Middle cerebral arteries

Anterior Choroidal artery


Supraclinoid segment
Cavernous
PComA segment
Petrous segment
Ophthalmic artery
Cervical segment
Anterior Cerebral Artery

A1 segment AComA A2 segment

Recurrent A. of Hubner Medial lenticulostriate


Branches of A2 segment ACA

Callosomarginal

Pericallosal

Frontopolar

Medial orbitofrontal
Middle Cerebral Artery

M3 segment

Lateral lenticulostriate

M2 segmnt
M1 segment
Cortical Branches Of MCA

Artery to the central sulcus (C)


Posterior parietal (P)

Ascending frontal (AF)

Angular (A)

Posterior temporal (T)


Vertebral Artery

Intracranial portion

Foramen magnum

Cervical portion

1st part of subclavian artery


Basilar Artery

BA

VA

VA

BA
Vertebro-Basilar Branches

PCA

SCA

BA
AICA

VA

PICA
Ant.& Post spinal arteries

Ant & Post. spinal arteries


Segments of the PICA

Supratonsillar

Anterior medullary Inferior Vermian

Lateral medullary Retrotonsillar

Posterior medullary Hemispheric


Vertebro-Basilar Arteries

Digital Subtraction Angiography


(DSA)
Posterior Cerebral Artery

Precommunicating-P1

PComA

Ambiant-P2

Quadrigeminal-P3
Branches of PCA

Posterior choroidal Parieto-occipital

Parieto-occipital
Calcarine

Posterior temporal
Circle of Willis
Circle of Willis

AComA
A1/ACA

Supraclinoid ICA

PComA

P1/PCA

BA
Cerebral veins
The cerebral venous system

• Superficial (cortical) veins


• Deep veins
• Medullary white matter
• Subependymal
• Dural sinuses
SUPERFICIAL VEINS
Vein of Trolard
Cortical Veins

Vein of Labbé
DEEP VEINS
VEINS OF
THE POSTERIOR CRANIAL FOSSA
Vein of Galen

Superior Vermian vein

Basal vein of Rosenthal

Precentral cerebellar vein

Digital Subtraction Angiography


Dural Sinuses
Superior
Superior sagittal sinus Sagittal
Inferior
Sagittal
Dura Straight
Mater
Transverse

Sigmoid
Superior Sagittal sinus Inferior Sagittal sinus Straight sinus

Cavernous sinus

Sigmoid sinus Lateral sinus

Internal Jugular vein


Thank You
Prof Dr Mahmoud El Sheikh