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

Neuro Anatomy

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radiology brain anatomt in sectional ct and mr images

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Radio-Anatomy BrainDr.DneshResdentDept.of RadodagnossR.N.T.Medca Coege UdapurIntroduction: - The parts are Cerebrum or forebran Mdbran PonsMedua obongata Cerebeum or hndbran Embryological development The bran and spna cord deveop from ectoderm arranged n a tubuar structure caed the neura tube Before the neura tube has competey cosed, t s dvsbe nto an enarged crana part and a cauda tubuar part. The enarged crana part forms the bran. The cauda tubuar part forms the spna cord. The anteror part of the neutra tube expands, and constrctons appear that create three regons, caed Prmary bran vesces : prosencephaon (forebran), Mesencephaon ( Mdbran ), Rhombencephaon (Hnd bran). PRIMARY BRAIN VESICLES &THEIR SUB DIVISIONSCerebrumThe cerebrum (or telencephalon) s pared structurecomposed of two cerebra hemspheres (eft and rght) each contanng a centra space, the atera ventrcetakes up most of the ntracrana cavty and es above the tentorum cerebeParts Incude-cerebra hemspheresbasa gangaofactory bubwhte matter tractscorpus caosumanteror commssurenterna capsueFronta LobeThe fronta obe es on the orbta pate of the fronta bone and s bound by ts vertca and horzonta pates. It s the area of the cerebrum posteror to the fronta poe, anteror to the centra (Roandc) sucus and superomeday to the atera sucus and tempora obeThe frontal pole s ananatomca andmark that corresponds to the anteror ponted end of a cerebra hemsphere. It contans the frontopolar cortex (FPC), or Brodmann area 10, whch s thought to contrbute to many aspects of cogntonBlood supplyMCA - atera fronta obeACA - meda fronta obemportant areas ncude:precentral gyruses anteror to thecentra sucus and anges anteroaterayas t moves superonferoycontans theprmary motor cortexprecentra sucus, premotor cortex, and suppementary motor areaeanterorysuperior frontal gyrusseperated from the mdde fronta gyrus by the superor fronta sucusmiddle frontal gyrusseperated from the nferor fronta gyrus by the nferor fronta sucusinferior frontal gyruspars opercuarsn posteror aspect(contans Broca's area)pars tranguarsV-shaped area anterory used a andmark to nd the pars opercuars and hence Broca's areaDWI & Far mages Showng Infarct Precentra GyrusPareta obeocatedbetween the fronta and occpta obes andunderyng the pareta boneThe obe extends from the centra sucus anterory, whch separates t from the fronta obe,to the pareto-occpta sucus posterory, whch separates tfrom the occpta obe. The atera sucus corresponds to ts nferoatera boundary, separatng t from the tempora obe.Meday, t s connedby the meda ongtudna ssure whch dvdes both cerebra hemspheres. Blood supplyMCAACA-meda pareta obePCA-posteror meda pareta obeSulci and gyriatera surfacepostcentra gyrus (prmary sensory area)superor pareta obuenferor pareta obue (Werncke's area)supramargna gyrusanguar gyrusmeda surfaceparacentra obueprecuneusMR Imagng Showng post centra gyra nfarctOccpta obeoccipital lobe s ocated n the posterior (back) regon of the cerebrum, superior to (above) the cerebeum Anterory pareto-occpta sucus separates tfrom the pareta obeImportant areas ncudeoccpta poengua gyrusoccptotempora (fusform) gyrus (Brodmann area 37)cacarne(vsua)cortexcuneusInfarct occpta obeTempora Lobeargey occupes the mdde crana fossaThe obe extends superory to the Syvan ssure, and posterory to an magnary ne; the atera paretotempora ne, whch separates the tempora obe from the nferor pareta obue superory and the occpta obe nferory. The mdde crana fossa forms ts anteror and nferor boundares.The tempora obe can be dvded nto two man sectons:neocortext (sometmes referred to smpy as tempora obe)atera and nferoatera surfacescomprsed of standard cerebra cortexmesa tempora obe (sometmes referred to as the mbc obe) ncudng the hppocampus, amygdaa, parahppocampa gyrus, uncus, dentate gyrusT2W mage showng nfarct tempora obeNon-enhanced CT showng hypodense regon wth oca edema nvovng basa parts of the eft tempora obe ncudng parahppocampa gyrus.PCA nfarcton nvovng the meda tempora obeSucinterhemispheric aso know as the medial longitudinal fssure, s a deep groove ocated n the mdne between both cerebra hemspheres and contans the fax cerebrlateral (Sylvian)sulcus-separates the fronta and pareta obes superory from the tempora obe nferory. The nsuar cortex s ocated mmedatey nterna to the Syvan ssure.central (Rolandic) sulcus-separates the fronta obe from the pareta obe, and aso separates the prmary motor cortex anterory from the prmary somatosensory cortex posterory callosal sulcus- sucus n the bran between the cnguate gyrus and corpus caosum, beow the ongtudna cerebra ssure.cingulate sulcus- on the meda wa of the cerebra cortex. The fronta and pareta obes are separated from the cnguate gyrus by the cnguate sucusmarginal sulcus aso known aspars marginalis) s the extenson of the cnguate sucus posterosuperory, separatng theparacentra obue from the precuneus on the meda surface of the cerebra hemspheres. It is an excellent landmark to help confrm the location of the central sulcus, whch ocated one sucus anteror to the margna sucus, on the other sde of the precentra gyrus.parieto-occipital fssurecalcarine fssure - ocated on the meda surface of the occpta obe and dvdes the vsua cortex (aka cacarne cortex) nto two. Beow the ssure s the nfracacarne regon, comprsed of the fusform gyrus and ngua gyrus, whst above the ssure s the cuneus.Cnguate sucus Caosa Sucus ost !ontrast Axial "R #mage of the brainost !ontrast sagittal $% &eighted "'R'#' Section at the level of (oramen "agnumCsterna Magna. Cervca Cord. Nasopharynx. Mandbe. Maxary Snus ost !ontrast Axial "R #mage of the brainost !ontrast sagittal $% &td "'R'#'Section at the level of medullaSgmod Snus Medua Interna |uguar Ven Cerebear Tons Orbts ICATemporaobeost !ontrast sagittal $% &td "'R'#' Section at the level of onsCerebear HemsphereVerms IV VentrcePonsBasar ArteryCavernous SnusMCPIACMastod Snus ost !ontrast Axial "R #mage of the brainost !ontrast sagittal $% &td "'R'#' Section at the level of "id BrainAqueduct of SyvusOrbtsPosteror Cerebra ArteryMdde Cerebra Artery MdbranFrontaLobeTempora LobeOccpta Lobe(ig' %') ost !ontrast Axial "R #mage of the brainost !ontrast sagittal $% &td "'R'#' Section at the level of the### *entricleOccpta LobeIII VentrceFronta obe $emporal +obe Sylvian (issure (ig' %', ost !ontrast Axial "R #mage of the brainost !ontrast sagittal $% &td "'R'#' Section at the level of $halamusSuperor Sagtta SnusOccpta LobeChorod Pexus . Interna Cerebra VenFronta HornThaamusTemp LobeInterna Capsue. PutamenCaudate NuceusFronta Lobeost !ontrast sagittal $% &td "'R'#'Section at the level of !orpus !allosumGenu of corpus caosum Spenum of corpus caosumChorod pexus wthn the body of atera ventrce ost !ontrast Axial "R #mage of the brainost !ontrast sagittal $% &td "'R'#' Section at the level of Body of !orpus !allosumPareta LobeBody of the Corpus CaosumFronta Lobe ost !ontrast Axial "R #mage of the brainost !ontrast sagittal $% &td "'R'#' Section above the !orpus !allosumPareta LobeFronta Lobe "R# BRA#- .SA/#$$A+ S0!$#1-S Grey MatterWhte MatterWhte MatterCerebeumGrey MatterFronta LobePareta LobeTempora LobeLatera Sucus Occpta LobeGyr of cerebra cortexSuc of cerebra CortexCerebeumFronta LobeTemporaLobeFronta LobeTempora LobePareta LobeOccptaLobeCerebeumFronta LobePareta LobeOrbtOccpta LobeTransverse snusCerebear HemsphereOptc NervePrecentra SucusLatera VentrceOccpta LobeMaxary snusCaudate NuceusCorpus caosumThaamusTonguePonsTentorum Cerebe Spenum of Corpus caosumPonsEthmod ar CesInferor nasaConchaMdbranFourth VentrceGenu of CorpusCaosumHypophyssThaamus Spenum of Corpus caosumGenu of corpus caosumPonsSuperorCocuusInferor CocuusNasa Nasa SeptumMeduaBody of corpus caosumThaamusCnguate GyrusGenu of corpuscaosumEthmod ar cesOra cavtySpenum of Corpus caosumFourth VentrceFrontaLobeMaxarySnusPareta LobeOccpta LobeCorpus CaosumThaamusCerebeumFronta LobeTemporaLobePareta LobeLatera VentrceOccpta LobeCerebeumFronta LobePareta LobeSuperor Tempora GyrusLatera SucusInferor Tempora GyrusMdde Tempora GyrusExterna Audtory Meatus. BoneInferor sagtta snusCorpus caosumInterna cerebra venVen of GaenSuperor sagtta snusPareta obeOccpta obeStraght snus. Verms. IV ventrceCerebear tonsMass ntermeda of thaamusSphenod SnusMRI BRAIN :CORONAL SECTIONS LongtudnaFssureStraght SnusSuperor Sagtta SnusSgmod SnusVermsStraght SnusCerebeumLatera Ventrce,Occpta HornArachnod VGreat CerebraVenTentorumCerebeFax CerebrLatera VentrceVerms ofCerebeumCerebeumSpenum ofCorpus caosumPosteror CerebraArterySuperor CerebearArteryForamen MagnumLatera VentrceInterna CerebraVenTentorum CerebeFourth VentrceCnguate GyrusChorod PexusSuperor CocuusCerebra AqueductCorpus CaosumThaamusPnea GandVertebra ArteryInsuaLatera SucusCerebra Pedunce OveCrus of FornxMdde CerebearPedunceCaudate NuceusThrd VentrceHppocampus PonsCorpus CaosumThaamusCerebraPedunceParahppocampagyrusLatera VentrceBody of FornxTempora Horn of Latera VentrceUncus of Tempora LobeThrd VentrceHppocampusInterna CapsueCaudate NuceusOptc TractInsuaLentform NuceusParotd GandAmygdaaHypothaamusInterna CapsueCnguate GyrusOptc NerveNasopharynxInterna Carottd ArteryLentform NuceusCaudate NuceusaLongtudnaFssureSuperor SagttaSnusLatera SucusParotd GandGenu Of Corpus CaosumTempora LobeEthmod SnusFronta LobeNasa TurbnateMassetorNasa SeptumNasaCavtyTongueMeda RectusFronta LobeLatera RectusInferor TurbnateSuperor RectusInferor RectusMaxary SnusToothGrey MatterSuperor Sagtta SnusWhte MatterEye BaMaxary SnusTongue !oronal Section of the Brain at the level of ituitary glandost !ontrast !oronal $% &eighted "R#spnpFronta obeCorpus caosumFronta hornCaudate nuceusIIIPtutary stakPtutary gandOptc nerveInterna carotd arteryCavernous snuslimbic systemThe limbic system s a compex system that conssts many of thembc obe, cortca areas and subcortca nuce that have connectons to the mbc obe.Key structures of the mbc system ncude:hppocampusparahppocampuscnguate gyrusbasoatera nuce of the amygdaasepta nucenuceus accumbenshypothaamus (mammary bodes)anteror nuceus of the thaamusAmygdaa(green)amygdaa s dented by the entorhna sucus.The amygdaa s a compexstructure, ocated dorsomeday n the tempora obe,formng the ventra superor, and meda was of the nferor horn of the atera ventrceCnguate gyruses on the meda aspect of the cerebra hemsphere. It forms a ma|or part of the mbc system whch has functons n emoton and behavour.extends from the subcaosa gyrus n the fronta obe anterory to the sthmus posterory.It foows the superor convexty of the corpus caosum separated from t by the caosa sucusThe anteror porton es nferor to the superor fronta gyrus separated from t by the cnguate sucus. The most anteror porton ends beow the rostrum of the corpus caosumThe mdde and most horzonta porton es nferor to the paracentra obue separated from t by the cnguate sucusIts posteror porton (posteror cnguate gyrus) es nferor to the precuneus separated from t by the subpareta sucus The posteror cnguate gyrus and sthmus e anteror to the occpta obe separated from t by the pareto-occpta sucusCnguate gyrusInsuaes wthn the atera sucus whch separates the tempora obe and the pareta obe dorsay. The overyng cortca areas formed by the fronta and tempora obes are known as opercua whte matter tractscommssurescorpus caosumanteror commssurehppocampa commssurehabenuar commssureposteror commssuresupraoptc commssureFornxforceps ma|orforceps mnornterna capsueexterna capsueextreme capsuecoronaradatacentrum semovaeoptc tract and radatonCorpus caosumnks the cerebra cortex of the eft and rght cerebra hemspheres and s the argest bre pathway n the brandvded nto four parts (anteror to posteror):rostrum (contnuous wth the amna termnas)genutrunk/bodyspenumForceps ma|or aso known as the posterior forceps, s a bre bunde whch connects the occpta obes and crosses the mdne va the spenum of the corpus caosumForceps mnor aso known as the anterior forceps, s a bre bunde whch connects the atera and meda surfaces of the fronta obes and crosses the mdne va the genu of the corpus caosuminternal capsulea deep subcortca structure that contans a concentraton of whte matter pro|ecton bres. These bres form the corona radata. hgh concentraton of both motor and sensory pro|ecton bresanterior limbes between the head of the caudate nuceus meday and and the entform nuceus ateraycontans the anteror thaamc radaton and frontopontne bresgenues meda to the apex of the entform nuceuscontans cortconucear bres (prevousy caed cortcobubar bres)posterior limbes between the thaamus meday and the entform nuceus ateraycortcospna bres yng n the anteror two-thrds of the posteror mbthe mdde thaamc radaton whch contans somatosensory bres from the ventra posteror thalamic nucleus retrolentiform partes behnd the entform nuceuscontans the gencuocacarne or optc radatonsublentiform partes beow the entform nuceuscontans the audtory radatonsExterna capsue stuated between the putamen and caustrumThe extreme capsule s a seres of whte matter tracts n the bran that run between the caustrum and nsuar cortexcorona radiata refer to a par of whte matter tracts seen at the eve of the atera ventrces. Superory they are contnuous wth the centrum semovae. Inferory these tracts converge as the nterna capsueThe centrum semiovale s a mass of whte matter, superor to the atera ventrces/corpus caosum, present n each of the cerebra hemspheresunder cerebra cortex.It has a sem-ova shape and contans pro|ecton, commssura, and assocaton bers. Inferory these bres are contnuous wth the corona radataDeep gray matterbasa gangacaudate nuceuscaudothaamc groovecorpus stratumentform nuceusgobus padusputamencaustrumBasal gangliaThe basal ganglia are a group of nuce n the bran that s nterconnected wth the cerebra cortex, thaam and branstemt contans three pared nuce:caudate nuceusputamen (together wth the caudate nuceus known as corpus stratum)gobus padus (together wth the putamen known as the entform nuceus)Functonay, two addtona nuce are aso part of the basa ganga:subthaamc nucesubstanta ngraThe claustrum s a vertca curved sheet of subcortca grey matter orented sagttay between the whte matter tracts of the externa capsue and extreme capsue. It s atera to the putamen and meda to the nsuar cortex.$halamus$halamus s a pared and symmetrca structure n the bran, and the man part of the dencephaon. It s the pathway through whch sgnas are sent from cerebrum to mdbran (branstem) va the cerebra pedunces and vce versa.The thaamus has many functons ncudng:transator of prethaamc nputs nto readabe formprocess and reay of sensory nformaton seectvey to varous parts of the cerebra cortexreguaton of seep and wakefunessthaamo-cortco-thaamc crcuts nvoved n conscousnessarousa, the eve of awareness, and actvty"idbrainmost rostra part of the branstem and sts above the pons and s ad|oned rostray to the thaamus. Durng deveopment, the mdbran forms from the mdde of three vesces that arse from the neura tubeWhen vewed n cross-secton, the mdbran can be dvded nto three portons:tectum (posteror)tegmentumcerebra pedunces (anteror)onspons s the mdde of the three parts of the branstem, sttng above the medua and beow the mdbran. It acts as a reay between the cerebeum and cerebra hemspheres.The pons has a bubous shape and has two man components - the ventral pons and the dorsal tegmentum. The ventral (or anterior) pons conssts of whte matter tracts (e.g. cortcospna, cortcobubar and cortcopontne tracts) wth transverse bres contrbutng to the buk of the pons.The dorsa tegmentum s contnuous wth the tegmentum of the medua and the mdbran. It contans mutpe whte matter tracts (e.g. meda ongtudna fasccuus, meda emnscus, atera emnscus, etc) and gray matter nuce (e.g. crana nerves).Wthn the dorsa tegmentum e four crana nerve nuce:trgemna nerve (CN V) - many motor and sensory nuce extendng from the pons to the upper cervca cordabducens nerve (CN VI) - motor nuceusfaca nerve (CN VII) - ncudng superor savary, motor and sotary tract nucevestbuocochear nerve (CN VIII) - ncudng vestbuar and cochear nuceonsBlood supply is through superor cerebear artery & pontne branches of basar arteryThe facial colliculus s notformed by the faca nerve nuceus, but by the bres of the faca nerve archng backwards around the abducens nerve (CN VI) nuceus before turnng forwards once more. The cocuus s an eevaton on the oor of the fourth ventrce.A eson nvovng the faca cocuus s therefore key to resut n faca cocuus syndromeby nvovng:abducens nerve (CN VI) nuceusfaca nerve (CN VII) bres at the genumeda ongtudna fasccuusPontne InfarctInfarct 6th crana nerve"edulla oblongataThe medulla oblongata (or smpy medulla) s the most cauda part of the branstem and sts between the pons nferory and spna cord superory. It s the transton from the spna cord to the brancontans the vta autonomc cardovascuar and respratory centers controng heart rate, bood pressure, and breathng. It s composed of grey matter, crana nerve (CN) nuce IX-to-XII, and whte matter tractsapproxmatey 3cm n ength and 2cm n greatest dameter2. Thecauda border of the medua s the 1st cervca spna nerves. The superor broad part of the medua |ons the pons"edulla oblongataMedua s separated nto two man parts:ventra (anteror) medua whch contans the ove, pyramda tracts, and CN 9-12 rootetstegmentum (dorsa) medua whch contan the CN nuce and whte matter tractsPyramds are pared structures ocated at the meda aspect of ventra medua and ank the anteror medan ssure. It contans the the cortcospna tracts. At the cauda end of pyramds the cortcospna tracts decussateOvary bodes are pared structures ocated at atera aspect of ventra medua, atera to the pyramds. They are separated from the pyramds by an anteroatera sucus (pre-ovary sucus). There s aso a post-ovary sucus atera to the ovary bodes. Ovary bodes contan the superor and arger nferor ovary nuceThe dorsa aspect of the medua contans the posteror medan sucus (most dorsa meda sucus) and more atera posteroatera sucus. Between these suc are the fasccuus gracs and nuce formng gracs tuberce at the mdne and fasccuus cuneatus and nuce formng cuneate tuberce more aterayThe superor dorsa aspect of medua forms the oor of the nferor 4th ventrce. It s occuped by the nferor cerebear pedunce stuated between the ower part of the fourth ventrce. The nferor dorsa and atera aspect of the medua s surrounded by the csterna magna (posteror cerebeomeduary cstern), and atera cerebeomeduary csternThe medan aperture (foramen of Magende) and the more superor atera apertures (foramna of Luschka) open at the eve of the pons, wth the canas pro|ectng to the eve of the medua regon and termnatng nto the csterna magna and atera cerebeomeduary cstern respectvey !erebellumThe cerebellumsts at the base of the brann the posteror crana fossa.three ssures: prmary (tentora), horzonta (petrosa), prebventra/prepyramda (suboccpta)two hemspheressnge medan verms!onnections to brainstemto mdbran:superor cerebear pedunces (bracha con|unctva)to pons: mdde cerebear pedunces (bracha ponts)to medua: nferor cerebear pedunces (restform bodes)Blood supplyThe cerebeum s essentay supped by three vesses:superor cerebear artery (SCA) (branch of the dsta basar)anteror nferor cerebear (AICA) (branch of the proxma basar)posteror nferor cerebear (PICA) (branch of the dsta vertebras)MenngesThe cerebral meninges surround the bran and s made up of three ayers (from outermost to nnermost):dura materarachnod materpa materThe dura mater can aso be known as pachymeninx. The arachnod mater and pa mater are coectvey known as the leptomeninges The mennges functon to protect the bran but aso provdes a framework for bood vesses, nerves, ymphatcs and CSF There are two potenta spaces:epdura (extradura) space - between the bone of the cranum and outer ayer of the dura matersubdura space - between the nner ayer of the dura mater and the arachnod materThere s one CSF-contanng rea space, subarachnod space, between the arachnod and pa mater.*entricular systemThe ventricular system n the bran s composed of CSF-ed ventrces and ther connectng foramnae. They are contnuous wth the centra spna cana.two atera ventrces thrd ventrcefourth ventrceThe nterconnectons between the ventrces occurs through the foowng:nterventrcuar foramen (of Monro): atera to thrdcerebra aqueduct (of Syvus): thrd to fourthmedan aperture (of Magende): fourth to csterna magna two atera apertures (of Luschka): fouth to quadrgemna cstern Both the csterna magna and the cstern of the great cerebra ven are n the subarachnod space. Ths space s contnuous wth the subarachnod space around the cord down to the eve of the cauda equna.THE END THANK YOU