Three-dimensional microsurgical anatomy of the basal aspect of the cerebrum: a fiber dissection study

OBJECTIVE Due to the unique nature of the basal structures of the cerebrum, only a limited portion is exposed during surgery, leading to potential risk of damage to surrounding structures. The white matter fiber tracts in the basal cerebrum may be more critical than the cortex in determining the extent of resection. A thorough understanding of the 3D anatomy of these fiber tracts is essential for planning safe and precise surgical approaches and provides an anatomical foundation for studying brain function. This study aimed to examine the topographical anatomy of the fiber tracts and subcortical gray matter in the basal cerebrum, as well as their anatomical relationships with the cerebral cortex, ventricles, and associated nuclei. METHODS Using fiber dissection techniques and magnification ranging from ×6 to ×40, the authors studied 10 formalin-fixed human brains. The study focused on the fiber tracts and subcortical nuclei in the basal cerebrum, including the hippocampus, amygdala, and nucleus accumbens, and their relationships were documented through 3D photography. RESULTS The topographical relationships between the commissural, projection, and association fibers and the significant nuclei in the basal cerebrum were identified. Notable landmarks related to the fiber tracts include the cortical gyri and sulci, major basal nuclei, and lateral ventricles. The fiber tracts also exhibited consistent interrelationships. CONCLUSIONS The 3D microsurgical anatomy of the basal cerebrum provides valuable insights for planning precise and safe surgical approaches and offers anatomical evidence for further studies on brain function.