RADIOLOGICAL ANATOMY OF

BRAIN
-PRESENTER
DR.N.CHANDANA (JR-1)
DEPT. OF RADIO-DIAGNOSIS
MAMATA MEDICAL COLLEGE
-MODERATOR
DR.SUBHASHINI (ASST.PROFESSOR)
EMBRYOLOGY
• CT and MRI are the mainstays of cerebral imaging.
• Anatomical details are far better displayed on MRI.
• Skull radiography plays a very little part in diagnosis,largely
being replaced by multislice CT.
BASIC DIFFERENCE ON MRI AND CT
• The brain consists of the cerebrum, cerebellum, and brainstem.
1. Cerebrum : largest part – left and right hemispheres divided by
interhemispheric fissure and falx cerebri.
2. Cerebellum : located posteriorly in the two thirds of the
posterior fossa, separated from the brainstem by the fourth
ventricle. The two cerebellar hemispheres are united by the
vermis as a midline structure.
3. Brainstem : in the anterior third of the posterior fossa, consist
of midbrain, pons and medulla.
CEREBRAL ENVELOPE (MENINGES)
• Outer fibrous - Dura mater.
• Avascular, lattice like - Arachnoid mater.
• Inner, vascular layer - Pia mater.
DURA MATER
• Has two layers: Outer periosteal layer
Inner meningeal layer (dura mater proper)
• Special dural folds – Falx and Tentorium.
• Falx separates the two cerebral hemispheres and it extends from
the crista galli to the internal occipital protuberance, where it
joins the tentorium.
• Tentorium separates the cerebrum from cerebellum.
ARACHNOID MATER

• The subdural space is between the dura mater and the arachnoid
into which haemorrhage may occur or pus forms.
• The subarachnoid space is between the arachnoid and the pia
mater which contains cerebral spinal fluid, which surrounds the
cerebral arteries and veins.
• The epidural space is located external to the dura mater.
PIA MATER
• The pia mater adheres to and actually follows the contours of
the brain

• All the meningeal layers fuse in the sella,hence there is no sub-

arachanoid space.
SUB-ARACHANOID CISTERNS
• Cisterns are pooling areas
for cerebrospinal fluid in the
brain that result from a
widening of the subarachnoid
space.
• Different cisterns are :
CISTERNA MAGNA- lies between the medulla and the
posteroinferior surface of the cerebellum. It continues below the
spinal subarachnoid space and receives cerebral spinal fluid from
the fourth ventricle. It is sometimes punctured percutaneously in
the midline to obtain cerebral spinal fluid for examination.
• Vertebral and posterior inferior cerebellar arteries travel through
lateral part.
• Contents : IX X XI cranial nerves.
• PONTINE CISTERN is anterior to both the pons and
medulla and contains the basilar artery and cranial nerves
V to XII.
• SUPRASELLAR CISTERN extends from the infundibulum
to the posterior surface of the frontal lobes contains the
circle of Willis
• INTERPEDUNCULAR CISTERN which contains the
terminal basilar artery and its branches and the III cranial
nerve.
• AMBIENT CISTERN surrounds the midbrain and transmits the
posterior cerebral and superior cerebellar arteries,basal veins
of Rosenthal and IV cranial nerve.
• QUADRIGEMINAL CISTERN lies adjacent to the cerebellum
and extends superiorly around the splenium of the corpus
callosum. It contains the posterior cerebral, posterior choroidal
and superior cerebellar arteries, IV cranial nerve.
• CISTERN OF THE LAMINA TERMINALIS is superior to the
chiasmatic cistern. It contains the anterior communicating
artery and leads into the CALLOSAL CISTERN, through which
the pericallosal artery travels.
 CEREBRAL HEMISPHERES
• The cerebral cortex is organized into
folds called gyri between which there are
CSF-filled grooves called sulci.
• The deeper and more anatomically
constant sulci are known as fissures.
• Sylvian fissure is in between the frontal and
the superior margin of the temporal lobe.
• Fissure of Rolando divides the
frontal and parietal lobes.
• Parieto-occipital fissure divides the
parietal and occipital lobes.
• Calcarine fissure on the occipital lobe.
• Transverse fissure divides the cerebrum from the cerebellum.
• Longitudinal fissure which divides the cerebrum into two
hemispheres.
• INSULA: it forms the inner surface of the cerebral cortex found deep to
the sylvian fissure.

Clinical Significance – loss of definition of insular cortex is an early sign

of acute infarct involving the middle cerebral artery.
DEEP STRUCTURES
• Caudate nucleus – lies in the concavity of
the lateral ventricle.
• Lentiform nucleus – laterally the larger
putamen and medial globus pallidus
• Internal capsule separates it from caudate
and thalamus
• Claustrum – thin sheet of gray matter
which lies between putamen and insula
• Separated medially from putamen by
external capsule
• Laterally bounded by a thin white matter
extreme capsule just deep to insula.
• Sub-thalamic nucleus and substantia nigra.
 DIENCEPHALON

• It comprises a large aggregate of grey matter, which lies

between the cerebral hemispheres and brainstem and which
borders the third ventricle.
THALAMUS

• Largest structure in the diencephalon and is made up of a

number of functionally important nuclei.
• The most dorsal nucleus is called the pulvinar.
• The two thalami are apposed in the midline at the interthalamic
adhesion.
 HYPOTHALAMUS
• The hypothalamus is situated below the thalamus and the basal
ganglia, forms the roof of the interpeduncular fossa and the floor
of third ventricle.
• It contains several complex nuclei, the mammillary bodies(anterior
to the interpeduncular fossa),the tuber cinereum (a protuberance
located behind the infundibulum), the infundibulum, the pituitary
stalk.
 PINEAL GLAND
• Hangs by a stalk joined to the posterior aspect of the
diencephalon and third ventricle.
• It lies in the midline above the superior colliculi.
• In adults, it is almost invariably calcified,
when seen on CT.
• It is not protected by the blood–brain barrier
and consequently enhances with contrast.
 PITUITARY

• Occupies the pituitary fossa in the body of the

sphenoid bone, in the midline above the sphenoid
sinus in between the cavernous sinuses.
• Consists of anterior lobe (adenohypophysis)
and posterior lobe (neurohypophysis)
• The neurohypophysis often has an
appearance on T1W images due to the
presence of vasopressin/ oxytocin termed as
pituitary ‘BRIGHT SPOT’
• Sella turcica is a saddle shaped depression in the body of
sphenoid bone which houses the pituitary gland.
• Diaphragma sella: Duramater which is attached anteriorly and
posteriorly to the anterior and posterior clinoids respectively.
• Infundibulum is the stalk or connection between the
hypothalamus and posterior pituitary.
LIMBIC SYSTEM
• The limbic system is a complex arrangement of interrelated cortical and
subcortical structures that play a major role in memory,olfaction and emotion.
• The core components:
• Hippocampal formation.
• Parahippocampal gyrus.
• Amygdala.
• Hypothalamus.
-Outer arch:
• Parahippocampal gyrus
• Cingulate gyrus
• Subcallosal gyrus

-Middle arch:
• Hippocampus proper
• Dentate gyrus
• Supracallosal gyrus
• Paraterminal gyrus

-Inner arch:
• Fornix
• Fimbria.
 WHITE MATTER OF CEREBRUM

-3 TYPES

• Commissural fibers-connects the

corresponding areas of 2 cerebral hemispheres.
• Projection fibers-connects the cerebral
cortex with the lower centres.
• Association fibers- connect different parts
of same cerebral hemispheres.
COMMISSURAL FIBERS

1. Corpus callosum
2. Anterior commissure
3. Posterior commissure
4. Commissure of fornix
5. Habenular commissure
CORPUS CALLOSUM

• The corpus callosum is the largest commissure.

• It forms a C-shaped structure, concave inferiorly.
• The rostrum projects infero-posteriorly from the
anterior genu.
• The genu fibres curve forward into the frontal lobes,
forming forceps minor.
• The body curves upwards and posteriorly towards
the splenium
• The fibres of the splenium curve backward into
the occipital lobes, as forceps major
• Anterior Commissure- is a bundle of myelinated fibers located
above the rostrum of the corpus callosum which link the olfactory
tracts and structures within the anterior temporal lobes including
the amygdala nuclear complexes.
• Posterior Commissure -located immediately below the pineal gland.
It carries fibres responsible for bilateral pupillary light reflex.
• Commissure of fornix – posterior part of fornix connecting the two
hippocampal nuclei.
• Habenular commissure- located above and adjacent to the pineal
body.
PROJECTION FIBERS
Internal capsule : Thick band of projection fibres carrying axons
going to and from the cerebral cortex at the level of the basal
ganglia and thalamus.
• Lies between caudate and thalamus medially and lentiform
nucleus laterally.
• It consists of
- Anterior limb
- Genu
- Posterior limb
- Retrolentiform part
- Sublentiform part
ASSOCIATION FIBERS
• Short association fibers.
• Long association fibers.
 CEREBELLUM
• The cerebellum consists of two hemispheres and a median structure: the
vermis.
• Horizontal fissure divides the cerebellar hemispheres into two lobes.
• The cerebellum is attached to the brainstem
by three bridges: the superior, middle and
inferior cerebellar peduncles.
BRAINSTEM
MIDBRAIN :
• Anteriorly two cerebral peduncles and posteriorly tectum. The tectum
represents the superior and inferior colliculi.
• Within the substance of the midbrain the red nuclei and the substantia
niagra which are are hypointense on T2W images due to their vascularity
and the substantia niagra due to their iron content.
• The tectum is composed of four rounded prominences collectively called
the corpora quadrigemina or quadrigeminal bodies.
• Cranial nerves arising in the midbrain are the III and the IV cranial nerves.
PONS :
• Acts as an intermediary between the medulla and the other parts of the brain.
• Has a bulbous anterior portion and a dorsal tegmentum.
• Posterior surface form the upper part of floor of 4th ventricle.
• V VI VII VIII cranial nerves arise from the junction with the medulla laterally.
• The ‘Michelin-man’ appearance of the brainstem denotes the pontomedullary
junction.
MEDULLA :
• Most caudal portion of the brainstem and continuous with the cervical cord at
the level of the foramen magnum.
• The pyramidal and olivary eminences can be defined, separated by a sulcus.
• All ascending and descending nerve tracts must pass through the medulla to
reach the brain.
• Cranial nerves IX X XI XII arise from the medulla.
• The IX and X nerves arise from a sulcus
posterolateral to the olive.
• The XII nerve arises from the pre-olivary sulcus.
DURAL VENOUS SINUSES
• These are valveless trabeculated venous channels and are
divide into
-superior group related to the vault
-basal group found at the skull base.
• The main components of the superior group sagittal, transverse
and straight sinuses.
• The basal group consists the cavernous, petrosal and
sphenoparietal sinuses.
• In the majority of individuals, most of its flow is directed to the
right transverse sinus with the straight sinus draining to the left
transverse sinus.
• The cavernous sinuses enhance with intravenous contrast on
both CT and MRI.
• Fat deposits can occur normally within the sinus and are seen
on CT as hypodense foci.
CSF FLOW WITH VENTRICLE ANATOMY
• Each lateral ventricle has a body, atrium and three horns named
after the lobe in which they lie: frontal, occipital, temporal.
• The third ventricle is a narrow slit-like vertical cavity between the
right and left diencephalon and its anterior wall is called the lamina
terminalis.
• The fourth ventricle is within the dorsal pons and upper medulla.
• There are paired lateral apertures (foramen of Luschka) and a
single median aperture (foramen of Magendie), which transmit
CSF into the cisterna magna.
• These provide routes of spread for disease out of the ventricular
system and into the subarachnoid space.
PHYSIOLOGICAL CALCIFICATIONS.
• Choroid Plexus: located within the atrium of the lateral ventricles.
Calcification of the choroid plexus is uncommon in patients younger than 10
years. With age the incidence increases, reaching 86% by the eighth
decade.
• Basal Ganglia: Calcification within the basal ganglia is common after the age
of 40 years but should be considered pathologic in persons younger than age
40 unless proved otherwise.
• Pineal Gland calcification is common > 30 years, rare in <10 years. However,
age is not the only important factor, displacement and size of the calcification
are significant.
• If calcification of the pineal gland is larger than 12 × 12 × 12 mm, the
possibility of a pineal gland–region tumor should be considered.
• Falx Calcification: commonly seen in the posterior interhemispheric fissure in
adults. If increased attenuation of the falx extends to the medial sulci, the
possibility of subarachnoid bleeding should be excluded.