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Radio-Anatomy

Brain
Dr.Dinesh
Resident
Dept.of Radiodiagnosis
R.N.T.Medical College Udaipur

Introduction: The parts are

Cerebrum or forebrain
Midbrain
Pons
Medulla oblongata
Cerebellum or hindbrain

Embryological
development
The brain and spinal cord develop from

ectoderm arranged in a tubular structure


called the neural tube

Before the neural tube has completely


closed, it is divisible into an enlarged cranial
part and a caudal tubular part.
The enlarged cranial part forms the brain.
The caudal tubular part forms the spinal
cord.
The anterior part of the neutral tube
expands, and constrictions appear that
create three regions, called
Primary brain vesicles : prosencephalon
(forebrain),
Mesencephalon ( Midbrain ),
Rhombencephalon (Hind brain).

PRIMARY BRAIN VESICLES &THEIR SUB


DIVISIONS

Cerebrum
The cerebrum (or telencephalon) is paired

structurecomposed of two cerebral hemispheres (left and


right) each containing a central space, the lateral
ventricle
takes up most of the intracranial cavity and lies above
the tentorium cerebelli
Parts Includecerebral hemispheres
basal ganglia
olfactory bulb
white matter tracts
corpus callosum
anterior commissure
internal capsule

Frontal Lobe
The frontal lobe lies on the orbital plate of the frontal bone

and is bound by its vertical and horizontal plates.


It is the area of the cerebrum posterior to the frontal pole,
anterior to the central (Rolandic) sulcus and
superomedially to the lateral sulcus and temporal lobe
The frontal pole is ananatomical landmark that
corresponds to the anterior pointed end of a cerebral
hemisphere. It contains the frontopolar cortex (FPC), or
Brodmann area 10, which is thought to contribute to many
aspects of cognition
Blood supply
MCA - lateral frontal lobe
ACA - medial frontal lobe

important areas include:


precentral gyrus
lies anterior to thecentral sulcus and angles
anterolaterallyas it moves superoinferioly
contains theprimary motor cortex
precentral sulcus, premotor cortex, and supplementary
motor arealieanteriorly
superior frontal gyrus
seperated from the middle frontal gyrus by the superior
frontal sulcus
middle frontal gyrus
seperated from the inferior frontal gyrus by the inferior
frontal sulcus
inferior frontal gyrus
pars opercularisin posterior aspect(contains Broca's area)
pars triangularis
V-shaped area anteriorly used a landmark to find the
pars opercularis and hence Broca's area

DWI & Flair images Showing Infarct Precentral

Gyrus

Parietal lobe
locatedbetween the frontal and occipital lobes

andunderlying the parietal bone


The lobe extends from the central sulcus anteriorly, which
separates it from the frontal lobe,to the parieto-occipital
sulcus posteriorly, which separates itfrom the occipital
lobe.
The lateral sulcus corresponds to its inferolateral boundary,
separating it from the temporal lobe.
Medially, it is confinedby the medial longitudinal fissure
which divides both cerebral hemispheres.
Blood supply
MCA
ACA-medial parietal lobe
PCA-posterior medial parietal lobe

Sulci and gyri


lateral surface
postcentral gyrus (primary sensory area)
superior parietal lobule
inferior parietal lobule (Wernicke's area)
supramarginal gyrus
angular gyrus
medial surface
paracentral lobule
precuneus

MR Imaging Showing post central gyral infarct

Occipital lobe
occipital lobe is located in the posterior (back)

region of the cerebrum, superior to (above) the


cerebellum
Anteriorly parieto-occipital sulcus separates itfrom
the parietal lobe
Important areas include
occipital pole
lingual gyrus
occipitotemporal (fusiform) gyrus (Brodmann area 37)
calcarine(visual)cortex
cuneus

Infarct occipital lobe

Temporal Lobe
largely occupies the middle cranial fossa
The lobe extends superiorly to the Sylvian fissure, and

posteriorly to an imaginary line; the lateral parietotemporal


line, which separates the temporal lobe from the inferior
parietal lobule superiorly and the occipital lobe inferiorly.
The middle cranial fossa forms its anterior and inferior
boundaries.
The temporal lobe can be divided into two main sections:
neocortext (sometimes referred to simply as temporal lobe)
lateral

and inferolateral surfaces


comprised of standard cerebral cortex
mesial temporal lobe (sometimes referred to as the limbic
lobe) including the hippocampus, amygdala, parahippocampal
gyrus, uncus, dentate gyrus

T2W image showing infarct temporal


lobe

Non-enhanced CT showing hypodense region

with local edema involving basal parts of the


left temporal lobe including parahippocampal
gyrus.

PCA infarction involving the medial temporal

lobe

Sulci
interhemispheric also know as the medial

longitudinal fissure, is a deep groove located in the


midline between both cerebral hemispheres and
contains the falx cerebri
lateral (Sylvian)sulcus-separates the frontal and
parietal lobes superiorly from the temporal lobe
inferiorly. The insular cortex is located immediately
internal to the Sylvian fissure.
central (Rolandic) sulcus-separates the frontal lobe
from the parietal lobe, and also separates the primary
motor cortex anteriorly from the primary
somatosensory cortex posteriorly
callosal sulcus- sulcus in the brain between the
cingulate gyrus and corpus callosum, below the
longitudinal cerebral fissure.

cingulate sulcus- on the medial wall of the cerebral

cortex. The frontal and parietal lobes are separated from


the cingulate gyrus by the cingulate sulcus
marginal sulcus also known aspars marginalis) is the
extension of the cingulate sulcus posterosuperiorly,
separating theparacentral lobule from the precuneus on
the medial surface of the cerebral hemispheres. It is an
excellent landmark to help confirm the location of the
central sulcus, which located one sulcus anterior to the
marginal sulcus, on the other side of the precentral gyrus.
parieto-occipital fissure
calcarine fissure - located on the medial surface of the
occipital lobe and divides the visual cortex (aka calcarine
cortex) into two. Below the fissure is the infracalcarine
region, comprised of the fusiform gyrus and lingual gyrus,
whilst above the fissure is the cuneus.

Cingulate sulcus Callosal Sulcus

. Maxillary
Sinus

. Nasopharynx

Post Contrast sagittal T1


Weighted M.R.I.
Section at the level of
Foramen Magnum
Cervical Cord

Cisterna Magna

. Mandible

Post Contrast Axial MR Image of the


brain

Orbits

Internal

Post Contrast sagittal T1


Jugular Vein
Wtd M.R.I.
Section at the level of
medulla

Sigmoid Sinus
Medulla
Cerebellar Tonsil
Post Contrast Axial MR Image of the
brain

Cavernous Sinus

ICA

Basilar Artery
Post Contrast sagittal T1
Wtd M.R.I.
Pons Section at the level of Pons
IV Ventricle

Temporal
lobe
IAC

Mastoid
Sinus

MCP

Vermis
Cerebellar
Hemispher
e

Orbits
Frontal
Lobe

Midbrain
Temporal Lobe
Aqueduct of Sylvius

Occipital Lobe

Middle Cerebral Artery Posterior Cerebral Artery


Post Contrast Axial MR Image of the
brain

Post Contrast sagittal T1


Wtd M.R.I.
Section at the level of Mi
Brain

Sylvian Fissure

Frontal lobe

III Ventricle

Occipital Lobe

emporal Lobe
Fig. 1.5 Post Contrast Axial MR Image of
the brain

Post Contrast sagittal T1


Wtd M.R.I.
SectionIII
atVentricle
the level of the

Frontal
Lobe
Frontal Horn

Caudate Nucleus

Putamen

. Internal Cerebral Vein

Internal Capsule

Choroid PlexusPost Contrast sagittal T1


Wtd M.R.I.
Section at the level of
Thalamus

Occipital Lobe

Temp Lobe
Thalamus

Superior Sagittal Sinus

Fig. 1.6 Post Contrast Axial MR Image of


the brain

Genu of corpus callosum

Choroid plexus within


the
Post Contrast sagittal T1
body of lateral
Wtd M.R.I.
ventricle
Section at the level of
Corpus Callosum

Splenium of corpus callosum

Frontal Lobe

Body of the
Corpus CallosumPost Contrast sagittal T1
Wtd M.R.I.
Section at the level of Body
of Corpus Callosum

Parietal Lobe

Post Contrast Axial MR Image of the


brain

Frontal Lobe

Post Contrast sagittal T1


Wtd M.R.I.
Section above the Corpus
Callosum

Parietal Lobe

Post Contrast Axial MR Image of the


brain

MRI BRAIN :SAGITTAL


SECTIONS

White Matter

Grey Matter

Parietal Lobe

Frontal Lobe

Lateral Sulcus
Grey Matter

White Matter

Occipital Lobe
Temporal Lobe

Cerebellum

Gyri of cerebral
cortex

Frontal
Lobe

Sulci of cerebral
Cortex

Temporal
Lobe

Cerebellum

Parietal Lobe

Frontal Lobe

Occipital
Lobe
Temporal
Lobe
Cerebellum

Parietal Lobe
Frontal Lobe

Occipital Lobe

Orbit

Transverse sinus

Cerebellar
Hemisphere

Precentral Sulcus
Lateral Ventricle

Occipital Lobe
Optic Nerve

Maxillary sinus

Corpus callosum
Thalamus

Caudate
Nucleus
Tentorium
Cerebell
Pons

Tongue

Thalamus
Genu of Corpus
Callosum

Hypophysis

Ethmoid air
Cells

Inferior nasal
Concha

Splenium of
Corpus
callosum
Midbrain

Fourth Ventricle

Pons

Body of
corpus
callosum
Genu of
corpus
callosum

Nasal
NasalSeptuml

Thalamus
Splenium
of Corpus
callosum
Superior
Colliculus
Inferior
Colliculus

Pons

Medulla

Cingulate Gyrus

Genu of corpus
callosum

Splenium of
Corpus
callosum

Ethmoid
air cells
Fourth Ventricle

Oral cavity

Corpus Callosum

Frontal
Lobe

Thalamus

Parietal Lobe

Occipital Lobe

Cerebellum
Maxillary
Sinus

Parietal Lobe

Frontal Lobe

Lateral Ventricle
Occipital Lobe

Temporal
Lobe
Cerebellum

Parietal Lobe

Frontal Lobe

Lateral Sulcus

Middle Temporal
Gyrus

Superior Temporal
Gyrus
Inferior Temporal
Gyrus

External Auditory
Meatus

Internal cerebral vein


. Bone
Inferior sagittal
sinus

Corpus callosum

Superior sagittal sinus

Parietal lobe

Vein of Galen
Occipital lobe

Mass
intermedia of
thalamus
Sphenoid Sinus

Straight sinus
. Vermis
. IV ventricle
Cerebellar tonsil

MRI BRAIN :CORONAL


SECTIONS

Superior Sagittal Sinus


Longitudinal
Fissure

Straight Sinus

Sigmoid Sinus
Vermis

Straight Sinus

Cerebellum

Lateral Ventricle
Occipital Horn

Arachnoid Villi

Falx Cerebri

Lateral Ventricle
Great Cerebral
Vein
Tentorium
Cerebelli

Vermis of
Cerebellum
Cerebellum

Lateral Ventricle

nternal Cerebral
Vein

Tentorium
Cerebelli

Splenium of
Corpus callosum
Posterior
Cerebral
Artery
Superior
Cerebellar
Artery

Fourth Ventricle
Foramen
Magnum

Cingulate Gyrus

Corpus Callosum

Choroid Plexus

Superior Colliculus

Thalamus

Cerebral Aqueduct

Pineal Gland

Vertebral Artery

Insula
Crus of Fornix

Lateral Sulcus

Cerebral Peduncle

Middle Cerebellar
Peduncle
Olive

Caudate Nucleus

Corpus Callosum
Thalamus

Third Ventricle
Hippocampus
Pons

Cerebral
Peduncle
Parahippocampal
gyrus

Lateral Ventricle

Body of Fornix
Third Ventricle

Uncus of Temporal
Lobe
Temporal Horn of
Lateral Ventricle

Hippocampus

Internal Capsule
Insula
Optic Tract

Caudate Nucleus
Lentiform
Nucleus
Hypothalam
us
Amygdala

Parotid
Gland

Cingulate Gyrus
Internal Capsule
Caudate
Nucleusa
Optic Nerve

Nasopharyn
x

Lentiform
Nucleus
Internal
Carottid
Artery

Longitudinal
Fissure

Lateral
Sulcus

Superior Sagittal
Sinus

Genu Of
Corpus
Callosum

Temporal
Lobe
Parotid
Gland

Frontal Lobe

Ethmoid Sinus
Nasal
Septum
Nasal
Cavity
Tongue

Nasal
Turbinate
Massetor

Frontal Lobe

Medial Rectus
Lateral
Rectus
Inferior
Turbinate

Superior
Rectus
Inferior
Rectus
Maxillary
Sinus
Tooth

Superior Sagittal Sinus


Grey Matter
White Matter

Eye Ball
Maxillary Sinus

Tongue

Frontal lobe

Corpus callosum
Frontal horn
III
Caudate nucleus
Optic nerve

Pituitary gland

Pituitary stalk

sp

Internal carotid artery


np
Cavernous sinus

Coronal Section of the Brain at the level of


Pituitary gland
Post Contrast Coronal T1 Weighted MRI

limbic system
The limbic system is a complex system that

consists mainly of thelimbic lobe, cortical areas and


subcortical nuclei that have connections to the
limbic lobe.
Key structures of the limbic system include:
hippocampus
parahippocampus
cingulate gyrus
basolateral nuclei of the amygdala
septal nuclei
nucleus accumbens
hypothalamus (mammillary bodies)
anterior nucleus of the thalamus

Amygdala

(green)

amygdala is identified by the entorhinal sulcus.


The amygdala is a complexstructure, located dorsomedially in the
temporal lobe,forming the ventral superior, and medial walls of the
inferior horn of the lateral ventricle

Cingulate gyrus
lies on the medial aspect of the cerebral

hemisphere. It forms a major part of the limbic


system which has functions in emotion and
behaviour.
extends from the subcallosal gyrus in the frontal
lobe anteriorly to the isthmus posteriorly.It follows
the superior convexity of the corpus callosum
separated from it by the callosal sulcus
The anterior portion lies inferior to the superior
frontal gyrus separated from it by the cingulate
sulcus.
The most anterior portion ends below the rostrum
of the corpus callosum

The middle and most horizontal portion lies

inferior to the paracentral lobule separated


from it by the cingulate sulcus
Its posterior portion (posterior cingulate
gyrus) lies inferior to the precuneus separated
from it by the subparietal sulcus
The posterior cingulate gyrus and isthmus lie
anterior to the occipital lobe separated from it
by the parieto-occipital sulcus

Cingulate gyrus

Insula
lies within the lateral

sulcus which separates


the temporal lobe and
the parietal lobe
dorsally.
The overlying cortical
areas formed by the
frontal and temporal
lobes are known as
opercula

white matter tracts


commissures
corpus callosum
anterior commissure
hippocampal
commissure
habenular
commissure
posterior commissure
supraoptic
commissure

Fornix
forceps major
forceps minor
internal capsule
external capsule
extreme capsule
coronaradiata
centrum semiovale
optic tract and radiation

Corpus callosum
links the cerebral cortex of the left and right

cerebral hemispheres and is the largest fibre


pathway in the brain
divided into four parts (anterior to posterior):
rostrum (continuous with the lamina terminalis)
genu
trunk/body
splenium

Forceps major also known as the posterior forceps, is a fibre bundle


which connects the occipital lobes and crosses the midline via the
splenium of the corpus callosum
Forceps minor also known as the anterior forceps, is a fibre bundle
which connects the lateral and medial surfaces of the frontal lobes and
crosses the midline via the genu of the corpus callosum

internal capsule
a deep subcortical structure that contains a concentration of white matter

projection fibres. These fibres form the corona radiata.


high concentration of both motor and sensory projection fibres
anterior limb
lies between the head of the caudate nucleus medially and and the lentiform nucleus

laterally
contains the anterior thalamic radiation and frontopontine fibres

genu
lies medial to the apex of the lentiform nucleus
contains corticonuclear fibres (previously called corticobulbar fibres)

posterior limb
lies between the thalamus medially and the lentiform nucleus laterally
corticospinal fibres lying in the anterior two-thirds of the posterior limb
the middle thalamic radiation which contains somatosensory fibres from the ventral
posterior thalamic nucleus
retrolentiform part
lies behind the lentiform nucleus
contains the geniculocalcarine or optic radiation

sublentiform part
lies below the lentiform nucleus
contains the auditory radiations

External capsule situated between the putamen and

claustrum
The extreme capsule is a series of white matter tracts in
the brain that run between the claustrum and insular cortex
corona radiata refer to a pair of white matter tracts seen
at the level of the lateral ventricles. Superiorly they are
continuous with the centrum semiovale. Inferiorly these
tracts converge as the internal capsule
The centrum semiovale is a mass of white matter,
superior to the lateral ventricles/corpus callosum, present
in each of the cerebral hemispheresunder cerebral cortex.It
has a semi-oval shape and contains projection,
commissural, and association fibers. Inferiorly these fibres
are continuous with the corona radiata

Deep gray matter


basal ganglia
caudate nucleus

caudothalamic groove

corpus striatum
lentiform nucleus

globus pallidus
putamen

claustrum

Basal ganglia
The basal ganglia are a group of nuclei in the brain that

is interconnected with the cerebral cortex, thalami and


brainstem
it contains three paired nuclei:
caudate nucleus
putamen (together with the caudate nucleus known as

corpus striatum)
globus pallidus (together with the putamen known as the
lentiform nucleus)

Functionally, two additional nuclei are also part of the

basal ganglia:
subthalamic nuclei
substantia nigra

The claustrum is a vertical curved sheet of

subcortical grey matter oriented sagittally


between the white matter tracts of the
external capsule and extreme capsule. It is
lateral to the putamen and medial to the
insular cortex.

Thalamus
Thalamus is a paired and symmetrical structure in the

brain, and the main part of the diencephalon.


It is the pathway through which signals are sent from
cerebrum to midbrain (brainstem) via the cerebral
peduncles and vice versa.
The thalamus has many functions including:
translator of prethalamic inputs into readable form
process and relay of sensory information selectively to

various parts of the cerebral cortex


regulation of sleep and wakefullness
thalamo-cortico-thalamic circuits involved in consciousness
arousal, the level of awareness, and activity

Midbrain
most rostral part of the brainstem and sits

above the pons and is adjoined rostrally to the


thalamus.
During development, the midbrain forms from
the middle of three vesicles that arise from
the neural tube
When viewed in cross-section, the midbrain
can be divided into three portions:
tectum (posterior)
tegmentum
cerebral peduncles (anterior)

Pons

pons is the middle of the three parts of the brainstem, sitting above the

medulla and below the midbrain.


It acts as a relay between the cerebellum and cerebral hemispheres.
The pons has a bulbous shape and has two main components - the ventral
pons and the dorsal tegmentum.
The ventral (or anterior) pons consists of white matter tracts (e.g.
corticospinal, corticobulbar and corticopontine tracts) with transverse fibres
contributing to the bulk of the pons.
The dorsal tegmentum is continuous with the tegmentum of the medulla
and the midbrain. It contains multiple white matter tracts (e.g. medial
longitudinal fasciculus, medial lemniscus, lateral lemniscus, etc) and gray
matter nuclei (e.g. cranial nerves).Within the dorsal tegmentum lie four
cranial nerve nuclei:
trigeminal nerve (CN V) - many motor and sensory nuclei extending from the

pons to the upper cervical cord


abducens nerve (CN VI) - motor nucleus
facial nerve (CN VII) - including superior salivary, motor and solitary tract nuclei
vestibulocochlear nerve (CN VIII) - including vestibular and cochlear nuclei

Pons
Blood supply is through superior cerebellar artery &

pontine branches of basilar artery


The facial colliculus is notformed by the facial nerve
nucleus, but by the fibres of the facial nerve arching
backwards around the abducens nerve (CN VI) nucleus
before turning forwards once more. The colliculus is an
elevation on the floor of the fourth ventricle.
A lesion involving the facial colliculus is therefore likely
to result in facial colliculus syndromeby involving:
abducens nerve (CN VI) nucleus
facial nerve (CN VII) fibres at the genu
medial longitudinal fasciculus

Pontine Infarct

Infarct 6th cranial nerve

Medulla oblongata
The medulla oblongata (or simply medulla) is the most

caudal part of the brainstem and sits between the pons


inferiorly and spinal cord superiorly. It is the transition from
the spinal cord to the brain
contains the vital autonomic cardiovascular and respiratory
centers controlling heart rate, blood pressure, and
breathing. It is composed of grey matter, cranial nerve
(CN) nuclei IX-to-XII, and white matter tracts
approximately 3cm in length and 2cm in greatest
diameter2.
Thecaudal border of the medulla is the 1st cervical spinal
nerves.
The superior broad part of the medulla joins the pons

Medulla oblongata
Medulla is separated into two main parts:
ventral (anterior) medulla which contains the olive, pyramidal tracts,
and CN 9-12 rootlets
tegmentum (dorsal) medulla which contain the CN nuclei and white
matter tracts
Pyramids are paired structures located at the medial aspect of

ventral medulla and flank the anterior median fissure. It contains


the the corticospinal tracts. At the caudal end of pyramids the
corticospinal tracts decussate
Olivary bodies are paired structures located at lateral aspect of
ventral medulla, lateral to the pyramids. They are separated from
the pyramids by an anterolateral sulcus (pre-olivary sulcus). There
is also a post-olivary sulcus lateral to the olivary bodies. Olivary
bodies contain the superior and larger inferior olivary nuclei

The dorsal aspect of the medulla contains the posterior median sulcus

(most dorsal medial sulcus) and more lateral posterolateral sulcus.


Between these sulci are the fasciculus gracilis and nuclei forming gracilis
tubercle at the midline and fasciculus cuneatus and nuclei forming
cuneate tubercle more laterally
The superior dorsal aspect of medulla forms the floor of the inferior 4th
ventricle. It is occupied by the inferior cerebellar peduncle situated
between the lower part of the fourth ventricle. The inferior dorsal and
lateral aspect of the medulla is surrounded by the cisterna magna
(posterior cerebellomedullary cistern), and lateral cerebellomedullary
cistern
The median aperture (foramen of Magendie) and the more superior
lateral apertures (foramina of Luschka) open at the level of the pons,
with the canals projecting to the level of the medulla region and
terminating into the cisterna magna and lateral cerebellomedullary
cistern respectively

Cerebellum
The cerebellumsits at the base of the brainin the

posterior cranial fossa.


three fissures: primary (tentorial), horizontal (petrosal),

prebiventral/prepyramidal (suboccipital)
two hemispheres
single median vermis

Connections to brainstem
to midbrain:superior cerebellar peduncles (brachia
conjunctiva)
to pons: middle cerebellar peduncles (brachia pontis)
to medulla: inferior cerebellar peduncles (restiform
bodies)

Blood supply
The cerebellum is essentially supplied by three
vessels:
superior cerebellar artery (SCA) (branch of the distal
basilar)
anterior inferior cerebellar (AICA) (branch of the
proximal basilar)
posterior inferior cerebellar (PICA) (branch of the
distal vertebrals)

Meninges
The cerebral meninges surround the brain and is made up of three

layers (from outermost to innermost):


dura mater
arachnoid mater
pia mater

The dura mater can also be known as pachymeninx. The arachnoid

mater and pia mater are collectively known as the leptomeninges


The meninges function to protect the brain but also provides a
framework for blood vessels, nerves, lymphatics and CSF
There are two potential spaces:
epidural (extradural) space - between the bone of the cranium and outer

layer of the dura mater


subdural space - between the inner layer of the dura mater and the
arachnoid mater

There is one CSF-containing real space, subarachnoid space, between

the arachnoid and pia mater.

Ventricular system
The ventricular system in the brain is composed of CSF-filled

ventricles and their connecting foraminae. They are continuous with the
central spinal canal.
two lateral ventricles
third ventricle
fourth ventricle

The interconnections between the ventricles occurs through the

following:
interventricular foramen (of Monro): lateral to third
cerebral aqueduct (of Sylvius): third to fourth
median aperture (of Magendie): fourth to cisterna magna
two lateral apertures (of Luschka): fouth to quadrigeminal cistern

Both the cisterna magna and the cistern of the great cerebral vein are

in the subarachnoid space. This space is continuous with the


subarachnoid space around the cord down to the level of the cauda
equina.

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