Cerebrum

Dr. Katharina Kian R. Demerre - Bacolod

PT 21
 cerebral hemispheres

• developed from telencephalon

• form largest part of the brain
• Each hemisphere consists of:
Ø covering of gray matter
Ø cortex and internal masses of gray matter
Ø basal nuclei
Ø lateral ventricle.
 SUBDIVISIONS
• situated in anterior and middle cranial
fossae of the skull and occupying the
whole concavity of the vault of the skull.
• two parts:
• diencephalon= forms central core
• telencephalon= forms cerebral
hemispheres
 DIENCEPHALON

• consists of 3rd ventricle and structures that

form its boundaries
• 3rd ventricle è cerebral aqueduct
(posterior)
• 3rd ventricle è interventricular foramina
(anterior)
• nerve fibers freely cross the boundaries.
 DIENCEPHALON
• inferior surface
- only area of the
diencephalon exposed to
the surface in the intact
brain.
 DIENCEPHALON
Gross Features
• formed by hypothalamic and
other structures:
oanterior to posterior:
§ optic chiasma
§ optic tract on either side
§ Infundibulum
§ tuber cinereum
§ mammillary bodies.
 DIENCEPHALON

o superior:
o concealed by the fornix
o Fornix - thick bundle of fibers that
originates in the hippocampus of
temporal lobe and arches posteriorly over
the thalamus to join the mammillary body.
 DIENCEPHALON
• superior wall
• formed by roof of 3rd ventricle
• consists of a layer of ependyma
• covered superiorly by a vascular
fold of pia mater (tela choroidea of
3rd ventricle)
• From roof of 3rd ventricle, choroid
plexuses, project downward from
the midline into the cavity of the
third ventricle.
• lateral surface DIENCEPHALON
- bounded by internal capsule of white
matter and consists of nerve fibers
that connect the cerebral cortex with
other parts of the brainstem and spinal
cord

• medial surface
- formed in its superior part by the
medial surface of the thalamus and
in its inferior part by the
hypothalamus.
 DIENCEPHALON
stria medullaris thalami
- forms a ridge along the superior
margin of the medial surface of
the diencephalon
- a discrete white matter tract that
directly connects frontolimbic
areas to the habenula, allowing
the forebrain to influence
midbrain monoaminergic output.
DIENCEPHALON
4 major parts:
• thalamus
• subthalamus
• epithalamus
• hypothalamus
 Thalamus
• large ovoid mass of gray matter
that forms the major part of the
diencephalon.
• serves as cell station to main
sensory systems except olfactory
pathway

🔍
 Thalamus
• situated on each side of 3rd ventricle
• anterior end=narrow and rounded;
forms posterior boundary of the
interventricular foramen
• posterior end: expanded to form the
• pulvinar
- which overhangs the superior
colliculus and the superior brachium.

• lateral geniculate body

- forms a small elevation on the under
aspect of the lateral portion of the
pulvinar.
 Thalamus
superior surface
• medially – covered by the tela choroidea and the
fornix.
• laterally – covered by ependyma and forms part
of the floor of the lateral ventricle
lateral part
• partially hidden by the choroid plexus of the lateral
ventricle
inferior surface
• continuous with tegmentum of midbrain
 Thalamus

• medial surface
- forms superior part of the lateral wall of 3rd
ventricle and usually connected to the
opposite thalamus by interthalamic
connection (interthalamic adhesion)

• lateral surface
- separated from the lentiform nucleus by
internal capsule
Thalamus

Function:
• Center where much of the information is
integrated and relayed to the cerebral
cortex and many other subcortical regions
• Relay center to the cerebral cortex
• plays a key role in the integration of
visceral and somatic functions
 Subthalamus

• lies inferior to thalamus and

situated between the thalamus and
tegmentum of the midbrain
• craniomedially related to the
hypothalamus.
• Location of cranial ends of the red
nuclei and the substantia nigra.
Subthalamus

• subthalamic nucleus
- shape of a biconvex lens
- has important connections with the
corpus striatum
- involved in the control of muscle
activity.
 Epithalamus
habenular nucleus
• small group of neurons situated medial
to the posterior surface of the thalamus.
• Receives afferent fibers from the
amygdaloid nucleus in the temporal
lobe through the stria medullaris
thalami
Epithalamus
habenular nucleus
• Some of the fibers of the stria
medullaris thalami cross the
midline and reach the habenular
nucleus of the opposite side è
form the habenular
commissure
Epithalamus

habenular nucleus
Function:
- center for integration of olfactory, visceral, and somatic
afferent pathways.
 pineal gland

• small, conical structure attached by the

pineal stalk to the diencephalon
• projects backward so that it lies posterior
to the midbrain
 pineal gland
Nearby landmarks:
• base of pineal stalk
• possesses a recess that is continuous
with the cavity of 3rd ventricle.
• superior part
• habenular commissure
• Inferior part
• Posterior commissure
 pineal gland
• 2 types of cells:
1. Pinealocytes
2. Glial cells
• Brain sand
• Concretions of calcified material
progressively accumulate within the
pineal gland with age.
Pineal gland

• possesses no nerve cells

• Receives from adrenergic sympathetic fibers derived
from the superior cervical sympathetic ganglia enter the
gland and run in association with the blood vessels and
the pinealocytes.
Pineal gland

• Melatonin
ØSecreted by the pineal gland
ØInhibitory property
ØPineal gland either directly inhibit the production of
hormones or indirectly inhibit the secretion of releasing
factors by the hypothalamus.
• does not possess a blood—brain barrier
 Pineal gland

• pineal activity exhibits a circadian

rhythm that is influenced by light.
• most active during darkness.
• probable nervous pathway
• from the retina è
suprachiasmatic nucleus of the
hypothalamus è tegmentum of
midbrain è pineal gland
Pineal gland

Melatonin
• present in high concentrations within the pineal gland.
• released into the blood or into the CSF of the third
ventricle where they pass to the anterior lobe of the
pituitary gland and inhibit the release of the
gonadotrophic hormone.
• plasma level rises in darkness and falls during the day.
• plays an important role in the regulation of reproductive
function.
 Hypothalamus

• extends from the region of the optic

chiasma to the caudal border of the
mammillary bodies
• lies below the hypothalamic sulcus on
the lateral wall of 3rd ventricle.
• placed close to the limbic system, the
thalamus, the ascending and
descending tracts, and the
hypophysis.
 Hypothalamus
Functions:
• nearly all the activities in the body are
influenced by the hypothalamus.
• controls and integrates the functions of
ANS and endocrine systems
• involved in regulation of:
• body temperature
• body fluids
• drives to eat and drink
• sexual behavior
• emotion
Hypothalamic Relations

• Anterior:
• pre-optic area:
• extends forward from the optic
chiasma to the lamina terminalis and
the anterior commissure
• Caudally
• merges into the tegmentum of the
midbrain.
• Superior
• thalamus
• Inferolateral
• subthalamic region lies
Hypothalamic
Relations

• When observed from below, the hypothalamus is seen to be related to the following
structures, from anterior to posterior:
• (1) the optic chiasma
• (2) the tuber cinereum and the infundibulum
• (3) the mammillary bodies.
 Optic Chiasma
• flattened bundle of nerve fibers situated at the
junction of the anterior wall and floor of the third
ventricle
• Landmarks:
• superior surface - attached to the lamina
terminalis
• Inferiorly - related to the hypophysis cerebri,
from which it is separated by the diaphragma
sellae.
• anterolateral corners - continuous with the optic
nerves
• posterolateral corners - continuous with the
optic tracts
 Optic Chiasma

• optic recess of the third ventricle,

lies on its superior surface.
• fibers originating from the nasal
half of each retina cross the
median plane at the chiasma to
enter the optic tract of the
opposite side.
Tuber cinereum
• convex mass of gray matter continuous
inferiorly with the infundibulum.
Infundibulum
• A hollow structure, continuous with the
posterior lobe of hypophysis cerebri.
Median eminence
• is a raised part of tuber cinereum to
which is attached the infundibulum.
Neurohypophysis
• composed of the median eminence, the
infundibulum, and the posterior lobe
(pars nervosa) of the hypophysis cerebri
• Corresponds to the posterior lobe of
pituitary gland.
Mamillary bodies
• 2 small hemispherical bodies
situated side by side posterior to
the tuber cinereum
• They possess a central core of gray
matter invested by a capsule of
myelinated nerve fibers.
posterior perforated substance
• Found posterior to the mammillary
bodies.
• These are small apertures which
transmit the central branches of the
posterior cerebral arteries.
Third Ventricle

• derived from the forebrain vesicle

• It is a slitlike cleft between the two
thalami
• anteriorly= communicates with lateral
ventricles through the interventricular
foramina (foramina of Monro)
• posteriorly= communicates with 4th
ventricle through the cerebral aqueduct.
• Third ventricle walls are lined with
ependyma
Cerebral hemisphere
 GENERAL APPEARANCE OF THE CEREBRAL
HEMISPHERES

• cerebral hemispheres
- largest part of the brain separated by a
deep midline sagittal fissure, the
longitudinal cerebral fissure
- fissure contains falx cerebri and anterior
cerebral arteries.

🔍
 GENERAL APPEARANCE OF THE CEREBRAL HEMISPHERES
• corpus callosum= connects the
hemispheres across the midline.
• tentorium cerebelli= separates the
cerebral hemispheres from the cerebellum

🔍
 GENERAL APPEARANCE OF THE CEREBRAL HEMISPHERES
• Gyrus (plural: gyri)
- is the name given to the bump ridges on the cerebral cortex (the outermost
layer of the brain).
- Found on the surface of the cerebral cortex and are made up of grey
matter, consisting of nerve cell bodies and dendrites.
- Increase the surface area of the cerebral cortex maximally; separated from
each other by sulci or fissure.
 GENERAL APPEARANCE OF THE CEREBRAL HEMISPHERES

• each hemisphere is divided into lobes

• Each lobe are named according to the
cranial bones under which they lie:
Ø frontal
Ø parietal
Ø temporal
Ø occipital lobes
 GENERAL APPEARANCE OF THE CEREBRAL HEMISPHERES

• Boundaries of each lobe, used for division:

Øcentral sulcus
Øparieto-occipital sulcus
Ølateral sulcus (Sylvian fissure)
Ø calcarine sulci
 Central sulcus
Central sulcus
• It runs downward and forward across
the lateral aspect of the hemisphere,
and its lower end is separated from the
posterior ramus of the lateral sulcus by
a narrow bridge of cortex.
• The only sulcus of any length on this
surface of the hemisphere that indents
the superomedial border and lies
between two parallel gyri.
 Central sulcus
Central sulcus
Landmarks
• Anterior: Motor cortex gyrus
- it can initiate the movements of the
opposite side of the body.
• Posterior: sensory cortex gyrus
- receives sensory information from the
opposite side of the body.
 Lateral sulcus
• a deep cleft found mainly on the inferior and
lateral surfaces of the cerebral hemisphere.
• consists of a short stem that divides into three
rami.
1. Anterior ramus
2. Ascending ramus
3. Posterior ramus
• insula (insular cortex)
- lies deep to the lateral surface
of the brain, completely covered
by the frontal, parietal, and
temporal opercula.
- It accounts for approximately
2% of the cortical surface.
 Parieto-occipital sulcus
•begins on the superior medial
margin of the hemisphere about 2
inches (5cm) anterior to the
occipital pole
•passes downward and anteriorly
on the medial surface to meet the
calcarine sulcus.
 Calcarine sulcus

• found on the medial surface of the

hemisphere.
• It commences under the posterior end
of the corpus callosum and arches
upward and backward to reach the
occipital pole, where it stops.
• calcarine sulcus is joined at an acute
angle by the parieto-occipital sulcus
about half-way along its length.
CEREBRAL HEMISPHERE
LOBES
Superolateral Surface

• frontal lobe
- area anterior to the central sulcus and
superior to the lateral sulcus.
- Divided by 3 sulci into 4 gyri
Øprecentral sulcus - runs parallel to the
central sulcus, and the precentral gyrus
lies between them.
ØSuperior sulcus
ØInferior frontal sulcus
 Superolateral Surface

• superior frontal gyrus

• middle frontal gyrus
• inferior frontal gyrus
• invaded by the anterior and
ascending rami of the lateral
sulcus
 Superolateral Surface

Parietal lobe
• posterior to central sulcus and
superior to lateral sulcus;
• it extends posteriorly as far as
the parieto-occipital sulcus
 Superolateral Surface

Parietal lobe
- lateral surface
- divided by 2 sulci into 3 gyri.
Ø postcentral sulcus= parallel to the
central sulcus, and the postcentral
gyrus lies between them.
Ø intraparietal sulcus= Running
posteriorly from the middle of the
postcentral sulcus
Ø superior parietal gyrus= Superior to
the intraparietal sulcus
Ø inferior parietal gyrus= inferior to the
intraparietal sulcus
 Inferolateral Surface
Temporal lobe
• inferior to the lateral sulcus
• lateral surface of the temporal lobe is
divided into 3 gyri by 2 sulci.
• superior and middle temporal
sulci = run parallel to the posterior
ramus of the lateral sulcus and
divide the temporal lobe into the
superior, middle, and inferior
temporal gyri
• inferior temporal gyrus is
continued onto the inferior surface of
the hemisphere
 Posterior Surface
occipital lobe
• occupies the small area behind
the parieto-occipital sulcus

🔍
Medial and Inferior Surfaces

• lobes not clearly defined on the medial

and inferior surfaces.
• corpus callosum
- largest commissure of the brain found
here.
 Medial and Inferior Surfaces

• Cingulate gyrus
- begins beneath anterior end of corpus
callosum and continues above the
corpus callosum until it reaches its
posterior end.
• Callosal sulcus
– separates the cingulate gyrus from
corpus callosum.
• Cingulate sulcus
- Separates cingulate gyrus from the
superior frontal gyrus.
 Medial Surface

• paracentral lobule
- surrounds the indentation produced by the
central sulcus on the superior border.
• anterior part= continuation of the precentral
gyrus on the superior lateral surface
• posterior part= continuation of the
postcentral gyrus
• Precuneus
- bounded anteriorly by the upturned posterior
end of the cingulate sulcus and posteriorly by
the parieto-occipital sulcus.
• Cuneus
- triangular area of cortex bounded above by
the parieto-occipital sulcus, inferiorly by the
calcarine sulcus, and posteriorly by the
superior medial margin.
• collateral sulcus
- inferior surface of the hemisphere; runs
anteriorly below the calcarine sulcus.
• lingual gyrus
- Between the collateral sulcus and the
calcarine sulcus.
• parahippocampal gyrus
- Anterior to the lingual gyrus; terminates in
front as the hooklike uncus.
Inferior Surface

• Medial occipitotemporal gyrus

- from the occipital pole to the temporal pole
- Boundaries:
- medially by the collateral and rhinal sulci
- laterally by the occipitotemporal sulcus.
Inferior Surface

• occipitotemporal gyrus
- Also known as the lateral
occipitotemporal gyrus
- Part of the temporal lobe and
occipital lobe
- Borders:
- Medially: parahippocampal gyrus,
lingual gyrus
- Laterally: inferior temporal gyrus
- lies lateral to the occipitotemporal
sulcus and is continuous with the
inferior temporal gyrus.
Inferior Surface, frontal lobe

• inferior surface of the frontal

lobe, the olfactory bulb and tract
overlie a sulcus called the
olfactory sulcus.
• Medial to the olfactory sulcus is
the gyrus rectus, and lateral to
the sulcus are a number of
orbital gyri.
INTERNAL STRUCTURE OF THE
CEREBRAL HEMISPHERES
Lateral Ventricles

• 2 lateral ventricles
• each occupy one cerebral hemisphere.
• Each is a roughly C-shaped cavity lined
with ependyma and filled with CSF.
• Parts:
• Body - occupies the parietal lobe, from
which 3 horns extends out.
• Anterior horn – extends to frontal lobe.
• Posterior horn – extends to occipital
lobe.
• Inferior horn - extends to temporal lobes
Lateral Ventricles
• communicates with the cavity of the 3rd ventricle through the
interventricular foramen
 Interventricular foramen
• Boundaries:
• anteriorly - anterior column of the fornix
• posteriorly - anterior end of the thalamus.
 Basal Nuclei
• AKA basal ganglia
• collection of masses of gray matter
situated within each cerebral hemisphere
Øcorpus striatum
Øamygdaloid nucleus
ØClaustrum
1. Corpus striatum
A. Caudate nucleus
B. Lentiform nucleus
a. Putamen
b. Globus Pallidus
C. Claustrum

• lateral to the thalamus

• almost completely divided by the internal capsule into the caudate nucleus and
the lentiform nucleus
A. caudate nucleus
- large C-shaped mass of gray
matter that is closely related to the
lateral ventricle lateral to the
thalamus
- lateral surface of the nucleus is
related to the internal capsule, which
separates it from the lentiform
nucleus.
B. lentiform nucleus
- wedge-shaped= broad convex base
directed laterally and its blade medially
- related medially to the internal capsule
(separates it from the caudate nucleus
and thalamus)
- related laterally to the external capsule
(separates it from the claustrum)
- Inferiorly at its anterior end, is
continuous with the caudate nucleus.
 C. Claustrum
• thin sheet of gray matter
separated from the lateral
surface of the lentiform nucleus
by the external capsule
• Lateral to the claustrum is the
subcortical white matter of the
insula.
• function unknown
 White Matter
• composed of myelinated nerve fibers of
different diameters supported by neuroglia.
• classified into three groups according to
their connections:
• commissural fibers
• association fibers
• projection fibers.
 Commissure fibers
Commissure fibers
• connect corresponding regions of the two
hemispheres.
• They are as follows:
1. corpus callosum
2. anterior commissure
3. posterior commissure
4. fornix
5. habenular commissure.
 Commissure fibers
1. corpus callosum
• largest commissure of the brain
• connects 2 cerebral hemispheres
• lies at the bottom of the
longitudinal fissure
 1. Corpus callosum
• Parts:
• rostrum= thin part of the anterior end
of the corpus callosum; prolonged
posteriorly to be continuous with the
upper end of the lamina terminalis
• genu= curved anterior end of the
corpus callosum that bends inferiorly
in front of the septum pellucidum
• body= arches posteriorly and ends as
the thickened posterior portion called
the splenium
1. Corpus callosum

boundaries:
• Traced laterally, the fibers of the genu
curve forward into the frontal lobes
and form the forceps minor
• The fibers of the body extend laterally
as the radiation of the corpus
callosum.
1. Corpus callosum
• Tapetum
- Some fibers that form the roof
and lateral wall of the posterior
horn of the lateral ventricle and the
lateral wall of the inferior horn of
the lateral ventricle;
• Forceps major
- Traced laterally, the fibers in the
splenium arch backward into the
occipital lobe.
2. Anterior commissure
• Its fibers that crosses the midline in
the lamina terminalis.
• Boundaries:
• laterally, a smaller or anterior
bundle curves forward on each
side toward the anterior
perforated substance and the
olfactory tract.
• larger, posterior bundle fibers
on each side and grooves the
inferior surface of the lentiform
nucleus to reach the temporal
lobes.
3. Posterior commissure

• bundle of nerve fibers that crosses

the midline immediately above the
opening of the cerebral aqueduct
into the 3rd ventricle
• related to the inferior part of the
stalk of the pineal gland.
 4. Fornix

• composed of myelinated nerve fibers and

constitutes the efferent system of the
hippocampus
• passes to the mammillary bodies of the
hypothalamus.
 4. Fornix
• nerve fibers first form the alveus è
converge to form the fimbria èon reaching
the posterior end of the hippocampus, arch
forward above the thalamus and below the
corpus callosum è form the posterior
columns of the fornix.
 4. Fornix
• commissure of the fornix
• consists of transverse fibers that
cross the midline from one column
to another just before the formation
of the body of the fornix.
• connect the hippocampal
formations of the two sides.
 5. Habenular commissure

• crosses the midline in the superior part of the

root of the pineal stalk.
• associated with the habenular nuclei, which
are situated on either side of the midline in this
region.
5. Habenular commissure
• habenular nuclei receive many afferents
from the amygdaloid nuclei and the
hippocampus.
• These afferent fibers pass to the habenular
nuclei in the stria medullaris thalami.
 Association fibers
• connect various cortical regions within the
same hemisphere
 Association fibers
• 2 parts:
• Short - lie immediately beneath
the cortex and connect adjacent
gyri; run transversely to the long
axis of the sulci.
• Long - collected into named
bundles.
 Association fibers
a. uncinate fasciculus
- connects the first motor speech area
and the gyri on the inferior surface of
the frontal lobe with the cortex of the
pole of the temporal lobe.

b. Cingulum
- long, curved fasciculus lying within the
white matter of the cingulate gyrus.
- connects the frontal and parietal lobes
with parahippocampal and adjacent
temporal cortical regions.
c. superior longitudinal fasciculus
- largest bundle of nerve fibers.
- connects the anterior part of the frontal lobe to the occipital and temporal lobes.
d. inferior longitudinal fasciculus
- runs anteriorly from the occipital lobe, passing lateral to the optic radiation, and is
distributed to the temporal lobe.
e. fronto-occipital fasciculus
- connects frontal lobe to the occipital
and temporal lobes.
- situated deep within the cerebral
hemisphere and related to the lateral
border of the caudate nucleus.
Projection fibers

a. internal capsule
- compact band of fibers at upper part of
the brainstem.
- Boundaries:
• medially= caudate nucleus and
thalamus
• laterally= lentiform nucleus
• bent to form an anterior limb and a
posterior limb, which are continuous
with each other at the genu
Projection fibers

b. corona radiata
- radiating projection fibers in all
directions to the cerebral cortex

• Most of the projection fibers lie

medial to the association fibers, but
they intersect the commissural fibers
of the corpus callosum and the
anterior commissure.
Projection fibers

c. optic radiation
- nerve fibers lying within the most
posterior part of the posterior limb
of the internal capsule and radiate
toward the calcarine sulcus.
 Other internal structures within hemispheres
Septum pellucidum
• thin vertical sheet of nervous tissue
consisting of white and gray matter
covered on either side by ependyma
• double membrane with a closed,
slitlike cavity between the membranes.
• stretches between fornix and corpus
callosum.
• Anteriorly= occupies the interval
between the body of the corpus
callosum and the rostrum.
• forms a partition between the anterior
horns of the lateral ventricles.
 Other internal structures within hemispheres
Tela choroidea
- two-layered fold of pia mater
situated between (boundaries):
Øthe fornix (superiorly)
Øroof of the third ventricle and
upper surfaces of the two
thalami (inferiorly)
- covered by ependyma and form
the choroid plexuses of the lateral
ventricle
 tela choroidea

blood supply
• similar to choroid plexuses of the
third and lateral ventricles
• derived from the choroidal
branches of the internal carotid
and basilar arteries
• venous blood drains into the
internal cerebral veins, which
unite to form the great cerebral
veinè joins the inferior sagittal
sinusè form the straight sinus.
Clinical Notes
Thalamic Lesions

• usually result from thrombosis or hemorrhage

• disability will be confined to the contralateral side of the body
• Clinical manifestation:
ØMajor impairment of all forms of sensation:
Ølight touch
Øtactile localization and discrimination
Øloss of appreciation of joint movements
Subthalamic lesions

• subthalamus should be regarded as one of the extrapyramidal motor

nuclei and has a large connection with the globus pallidus.
• Lesions result in sudden, forceful involuntary movements in a contralateral
extremity.
• movements may be jerky (choreiform) or violent (ballistic).
Pineal gland

• As the result of regressive changes that occur with age, calcareous

concretions accumulate within the glial cells and connective tissue of the
gland.
• useful as landmark in determining whether the pineal gland has been
displaced laterally by a space-occupying lesion
• pineal tumors or tumors of neighboring areas of nervous tissue that may
press on the pineal gland has shown severe alteration of reproductive
function.
Hypothalamic Syndromes

• lesions may be from infection, trauma, or vascular disorders

• abnormalities include:
Øgenital hypoplasia or atrophy
Ødiabetes insipidus
ØObesity
Ødisturbances of sleep
Øirregular pyrexia
Øemaciation
• Some of these disorders may occur together, such as in the
adiposogenital dystrophy syndrome.
Cerebral Cortex Lesions

• precentral gyrus lesions ècontralateral hemiparesis,

• postcentral gyrus lesions è contralateral hemisensory loss
• frontal lobe lesions è loss of attention span or change in social behavior
• cerebral cortex degeneration èdementia symptoms
 Lateral Ventricles

• Hydrocephalus
- distention of the ventricle from blockage
of CSF outflow.

• Each lateral ventricle contains about 7 to

10 mL of cerebrospinal fluid (CSF)
• CSF is produced in the choroid plexus of
the lateral ventricle and normally drains
into the third ventricle through the
interventricular foramen (foramen of
Monro)
Lateral Ventricles

• choroid plexus
- continuous with that of the third ventricle through the interventricular
foramen.
• Among the ventricles, the largest is located where the body and posterior
and inferior horns join, where it may become calcified with age.
Basal Nuclei

Øcaudate nucleus
Øthe lentiform nucleus
Øthe amygdaloid nucleus
ØClaustrum

• caudate or lentiform nuclei tumorsè motor or sensory symptoms on the

opposite side of the body.
• anterior two thirds of the posterior limb of the internal capsule tumors è
progressive spastic hemiplegia
• posteriorly situated tumors èimpairment of sensation on the opposite
side.
Cerebral Commisures

• The major commissure is the large corpus callosum.

• failed development of corpus callosum= no definite signs or symptoms
appear.
• destroyed corpus callosum= each hemisphere becomes isolated; patient
responds as if he or she has two separate brains.
• general intelligence and behavior appear normal
• object placed on right hand will not be recognizable if transferred on
the left
Internal Capsule

• Internal capsule hemorrhage è contralateral effects

- The most common cause of arterial hemorrhage is atheromatous
degeneration in an artery in a patient with high blood pressure.
Alzheimer disease

• degenerative disease occurring in middle to late life

• cause is unknown but evidence suggests genetic predisposition.
• mutations in App, presenilin I, and presenilin 2
• Clinical manifestation:
ØEarly memory loss
Øa disintegration of personality
Øcomplete disorientation
Ødeterioration in speech
Ørestlessness
• late stages= patient may become mute, incontinent, and bedridden
Alzheimer disease

• early sites include the hippocampus, the entorhinal cortex, and the
associated areas of the cerebral cortex.
• senile plaques are found in the atrophic cortex
• result from the accumulation of several proteins around deposits of
beta amyloid.
Alzheimer disease

• In the center of each plaque is an extracellular collection of degenerating

nervous tissue; surrounding the core is a rim of large abnormal neuronal
processes, filled with neurofibrillary tangles