normal cortical anatomy

Normal CorticalAnatomy

MGH

Massachusetts General HospitalHarvard Medical School

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NORMAL CORTICAL ANATOMY

• Sagittal• Axial• Coronal• The Central Sulcus

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Sagittal Neuroanatomy

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Subcallosal gyrusGyrus rectus

Parietooccipital sulcus

Fastigium, fourth ventricle

Cingulate gyrus

Calcarine sulcus

Marginal ramus of Cingulate sulcus

Superior parietal lobule

Paracentral lobule

Cingulate sulcusSuperior frontal gyrus

Cuneus

Lingual gyrus

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Gyrus rectus

Parietooccipital sulcus

Cingulate gyrus

Calcarine sulcus

Lingual gyrus

Marginal ramus of Cingulate sulcus

Superior parietal lobule

Cingulate sulcus

Caudothallamic groove

Precuneus

Central sulcus

Cuneus

Precentral gyrus

Frontomarginal gyrus

Superior frontal gyrus

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Parietooccipital sulcus

Calcarine sulcus

Superior parietal lobule

Marginal ramus of Cingulate sulcus

Central sulcusPrecentral

sulcus

Precuneus

Corona radiataSuperior frontal

gyrus

Lingual gyrus Inferior occipital gyrus

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Inferior temporal gyrus Temporal horn, lateral ventricle

Central sulcus

Posterior orbital gyrus

Frontomarginal gyrus

Medial orbital gyrus

Frontopolar gyrus

Parietooccipital sulcus

Lingual gyrusInferior occipital gyrus

Superior occipital gyrus

Middle occipital gyrus

Superior parietal lobule

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Central sulcus

Inferior Temporal gyrus

Middle Temporal gyrus

Superior Temporal gyrus

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Central sulcus

Lingual gyrus

Inferior occipital gyrus

Superior parietal gyrus

Middle occipital gyrus

Superior occipital gyrus

Inferior Temporal gyrusMiddle Temporal gyrus

Superior Temporal gyrus

Posterior orbital gyrus

Anterior orbital gyrus

Frontomarginal gyrus

Inferior frontal gyrus

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Inferior Temporal gyrus

Superior Temporal sulcusSuperior Temporal gyrus

Anterior occipital sulcus

Superior frontal sulcus

Precentral sulcus

Central sulcusPostcentral sulcus

Angular gyrus

Lateral fissure, posterior segment

Inferior frontal gyrus,pars orbitalis

Middle Temporal gyrus

Inferior occipital gyrus

Middle occipital gyrus

Inferior frontal gyrus,pars triangularis

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Axial Neuroanatomy

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Superior Temporal gyrus

Middle Temporal gyrus

Inferior Temporal gyrus

Fusiform gyrus

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Superior Temporal gyrus

Middle Temporal gyrus

Inferior Temporal gyrus

Parahippocampal gyrus

Hippocampal gyrus

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Temporo-occipital fissure

Inferior occipital gyrus

Lingual gyrusGyrus descendens

Superior Temporal gyrus

Middle Temporal gyrus

Inferior Temporal gyrus

Amygdala Hippocampus

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Gyrus rectus

Olfactory sulcusMedial orbital gyrusSubcallosal gyrus

Posterior orbital gyrus

Temporo-occipital fissure

Middle occipital gyrus

Lingual gyrus

Amygdala

Hippocampus

Superior Temporal gyrus

Middle Temporal gyrus

Inferior Temporal gyrus

Gyrus descendens

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Superior Temporal gyrus

Middle Temporal gyrus

Gyrus rectus

Olfactory sulcus Medial orbital gyrus

Anterior orbital gyrus

Posterior orbital gyrus

Lingual gyrus

Parahippocampal gyrus

Calcarine sulcus

CuneusGyrus descendens

Temporo-occipital fissure

Middle occipital gyrusIntra-occipital sulcus

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Superior frontal gyrus

Anterior orbital gyrus

Posterior orbital gyrus

Frontomarginal gyrus

Cingulate gyrus

Superior occipital gyrusIntra-occipital sulcusMiddle occipital gyrus

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Superior occipital gyrusIntra-occipital sulcus

Middle occipital gyrus

Cingulate gyrus

Parieto-occipital fissure

Calcarine sulcus

Cuneus

Middle temporal gyrus

Superior temporal sulcus

Superior temporal gyrus

Insula

Inferior frontal gyrus,pars orbitalis

Superior frontal gyrus Middle frontal gyrus

Inferior frontal gyrus,pars opercularis

Lateral fissure

Lateral fissure

Inferior parietal gyrus

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Middle occipital gyrus

Superior temporal gyrus

Intra-occipital sulcus

Superior frontal gyrus

Central sulcus

Superior occipital gyrusParieto-occipital sulcus

Superior temporal sulcus

Lateral fissure

Inferior parietal gyrus

Postcentral gyrus

Lateral fissure

Middle frontal gyrus

Inferior frontal gyrus

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Superior occipital gyrus

CuneusIntra-occipital sulcus

Middle occipital gyrus

Central sulcus

Precentral sulcus

Precentral gyrus

Central sulcus

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Postcentral sulcus

Superior frontal sulcus

Central sulcus

Intraparietal sulcus

Superior frontal gyrus

Middle frontal gyrus

Superior parietal gyrus

Centrum semiovale

Parietooccipital sulcus

Precuneus

Angular gyrus

Central sulcus

Inferior frontal gyrus

Supramarginal gyrus

Postcentral sulcus

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Postcentral sulcus

Central sulcus

Superior frontal sulcus

Pars marginalis

Intraparietal sulcus

Superior frontal gyrus

Middle frontal gyrus

Superior parietal gyrus

Angular gyrus

Supramarginal gyrus

Intraparietal sulcus

Central sulcus

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Central sulcus

Postcentral sulcus

Superior frontal sulcus

Precentral sulcus

Pars marginalis

Intraparietal sulcus

Superior frontal gyrus

Middle frontal gyrus

Superior parietal gyrus

Angular gyrus

Postcentral gyrus

Supramarginal gyrus

Precentral gyrus

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Central sulcus

Postcentral sulcus

Superior frontal sulcus

Precentral sulcus

Pars marginalisIntraparietal sulcus

Superior frontal gyrus

Middle frontal gyrus

Precuneus

Paracentral lobule

Superior parietal gyrus

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Coronal Neuroanatomy

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Olfactory bulb

Gyrus rectusMedial Orbital gyrus

Inferior Frontal gyrusSuperior Frontal gyrus

Middle Frontal gyrus

Interhemispheric Fissure

Inferior Frontal gyrus

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Forceps

minor

Olfactory SulcusLateral orbital gyrus

Inferior Frontal gyrus

Superior Frontal gyrusSuperior Frontal sulcus

Middle Frontal gyrus

Medial Orbital gyrus Gyrus rectusAnterior Orbital gyrus

Lateral orbital sulcus

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Inferior Frontal gyruspars opercularis

Superior Frontal gyrus Middle Frontal gyrus

Sylvian Fissure

Posterior Orbital gyrus

Inferior Temporal gyrus

Cingulate gyrusCircular insular sulcus

Olfactory Sulcus

Superior Temporal gyrus

Middle Temporal gyrus

Inferior Frontal sulcusshort insular gyrus

Gyrus rectusMedial Orbital gyrus

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Superior Frontal gyrusSuperior Frontal sulcus

Middle Frontal gyrus

Superior Temporal Sulcus

Sylvian Fissure

Amygdala

Precentral sulcus

Anterior commissure

Cingulate sulcus

Superior Temporal gyrus

Middle Temporal gyrus

Inferior Temporal gyrus

Precentral gyrus

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Superior Frontal gyrus

Middle Frontal gyrus

Superior Temporal gyrus

Middle Temporal gyrus

Superior Temporal Sulcus

Sylvian Fissure

Heschl’s gyrus

Inferior Temporal sulcus

Inferior Temporal gyrusAmygdala

Ambient gyrus

Entorhinal area

Cingulate gyrus

Superior Frontal sulcus

Precentral sulcus

Precentral gyrus

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Superior Frontal gyrus

Middle Frontal gyrus

Superior Temporal gyrus

Middle Temporal gyrus

Inferior Temporal gyrus

Fusiform gyrus

Hippocampus

CA1, cornu ammonisParahippocampal gyrus

Central Sulcus

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Paracentral lobule

Superior Temporal gyrus

Middle Temporal gyrus

Inferior Temporal gyrus

Central Sulcus

Postcentral gyrus

Cingulate gyrusIntraparietal sulcus

Fusiform gyrusCollateral sulcus

Parahippocampal gyrus

Supramarginal gyrus

Intraparietal sulcus

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Superior Temporal gyrus

Middle Temporal gyrus

Inferior temporal gyrus

Fusiform gyrus

Central sulcusParacentral lobule

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Fusiform gyrusLingual gyrus

Calcarine sulcus Cingulate gyrus

Inferior temporal gyrus

Middle temporal gyrus

Supramarginal gyrus

Intraparietal sulcus

Central sulcus

Paracentral lobule

Postcentral gyrus

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Lingual gyrus

Calcarine sulcus

Superior parietal lobuleprecuneus

Cingulate gyrus

Tentorium cerebelli

Fusiform gyrus

Inferior parietal lobule

Middle occipital gyrus

Inferior occipital

gyrus

Lingual gyrus

Collateral sulcus

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The Central Sulcus

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• superior frontal sulcus - pre CS sign

• sigmoidal Hook sign• pars bracket sign• Bifid post-CS sign• thin postcentral gyrus sign• intraparital sulcus - post-CS• midline sulcus sign

The Central Sulcus (CS)*

*Naidich & Brightbill. Int J Neurorad 1996;2:313-338

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• Superior frontal sulcus - preCS sign– the posterior end of the superior frontal

sulcus joins the precentral sulcus in 85%

The Central Sulcus (CS)

Precentral sulcus

Superior frontal sulcus

Precentral gyrus

Central sulcus

Superior frontal gyrus

Superior frontal sulcus

Precentral sulcus

Precentral gyrus

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• Sigmoid “Hook”– hooklike

configuration of the posterior surface of the precentral gyrus

– the “hook” corresponds to the motor hand area.

– The “hook” is well seen on CT (89%) and MRI (98%).

The Central Sulcus (CS)

Precentral sulcus

Central sulcus

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• pars bracket sign– The paired pars

marginalis form a “bracket” to each side of the interhemispheric fissure at or behind the central sulcus (96%).

The Central Sulcus (CS)

Precentral sulcus

Superior frontal sulcus

Precentral gyrus

Central sulcus

Pars bracket Paracentral lobule

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• pars bracket sign

The Central Sulcus (CS)

Precentral sulcus

Superior frontal sulcus

Precentral gyrus

Central sulcus

Pars bracketPars bracket

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• Bifid post-CS sign– the post-CS is bifid (85%).– The bifid post-CS encloses the lateral end of

the pars marginalis (88%).

The Central Sulcus (CS)

Precentral sulcus

Precentral gyrus

Central sulcus

Postcentral sulcus

Pars bracket

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Central sulcus

Postcentral sulcus

Central sulcus Central sulcus

Postcentral sulcus

Postcentral sulcus

Pars bracketPars bracket

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• Thin post-CG sign– the postcentral gyrus is

thinner than the precentral gyrus (98%).

The Central Sulcus (CS)Precentral

gyrus

Postcentral gyrus

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• Intraparietal Sulcus (IPS) and the post-CS– in axial MRI, the IPS intersects the post-CS

(99%).

The Central Sulcus (CS)

Pars bracket

IPS

Postcentral sulcus

IPS

Pars bracket

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Postcentral sulcus

IPS

Postcentral sulcus

IPS

Postcentral sulcus

IPS

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Precentral sulcus

Superior frontal sulcus

Precentral gyrus Central sulcus

Superior frontal gyrus

• Midline Sulcus sign– the most prominent

convexity sulcus that reaches the midline interhemispheric fissure is the CS (70%).

The Central Sulcus (CS)

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The Central Sulcus (CS)

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SFS-preCS sign

Hook sign

Pars bracket sign

Bifid post-CS sign

Thin postcentral gyrus sign

IPS - postCS sign

The Central Sulcus (CS)