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Introduction: Arachnoid cysts are non-neoplastic accumulations of cerebrospinal fluid formed within partitioned layers of the arachnoid mater. They represent about 1% of all intracranial masses in humans. Most arachnoid cysts present in the middle cranial fossa, but few occur along the cerebral convexity. Gross imaging of cerebral convexity arachnoid cysts (CCACs) is extremely scarce. The purpose of this study is to conduct a focused systematic review of CCACs and report their defining clinical characteristics. Methods: A systematic literature review was conducted to compile and summarize primary sources of anatomical and clinical information about CCACs. A large CCAC was discovered and dissected in a human cadaver. The CCAC was photographed in situ, and its impacts on contiguous gyri and sulci were documented and presented as a representative example of a CCAC. Results: CCAC formation is attributed to congenital (primary) or trauma-related (secondary) etiologies. While they are often asymptomatic, CCAC location and size can influence symptomology. The anticipated increase in intracranial pressure can elicit mild (e.g., headache) to severe (e.g., seizure, hydrocephalus) sequelae. The present study exhibits a remarkably large CCAC that developed within the left central sulcus, displacing the precentral and postcentral gyri. The central sulcus artery and vein were present and appeared unaffected. Conclusions: Management of CCACs can range from close observation with no intervention in asymptomatic cases to surgical intervention. Typical surgical options include microsurgical fenestration via craniotomy, neuroendoscopic fenestration, and various forms of shunting. The efficacy of one surgical approach over another remains highly debated. As CCACs are mostly diagnosed with CT and/or MRI, gross imaging of CCACs is extremely rare. This study provides clinical anatomists, neurologists, and neurosurgeons with visual insight and perspective into the physical and clinical characteristics of CCACs.

الملخص: أهداف البحث: يمكن التعرف بسهولة على التلم و تلافيف من المخ بمساعدة الأشعة، ولكن من الصعب تحديد موقعها أثناء العمليات الجراحية بسبب الاختلافات التشريحية والنهج الجراحي للتلم من خلال فتحة صغيرة. لذلك، تم إجراء هذه الدراسة لتحديد موقع التلم الرئيسي للدماغ باستخدام العديد من المعالم التشريحية في عينات الدماغ الجثة وصور الأشعة المقطعية. طريقة البحث: تمت دراسة 31 عينة دماغ جثة (17 يمينا و 14 يسارا) من جنس(ذكر او انثى) غير معروف. تمت دراسة 21 معلمة تتعلق بتلميع الدماغ المهم. كما تمت دراسة صور الأشعة المقطعية لما مجموعه 150 مريضا تحت ثلاث فئات عمرية. تم تصنيف معرف المريض على أنه 50 عاما تحت كل فئة عمرية أي 20-40 عاما و 41-60 عاما و 61-80 عاما. تم دراسة 10 معلمات. النتائج: في عينة الدماغ الجثة على المقارنة اليمنى واليسرى أظهر الجزء الخلفي فقط من التلم الكلسي فرقا كبيرا. في التصوير المقطعي المحوسب ضمن الفئة العمرية، تمت مقارنة الجانب الأيمن والأيسر في كل من الذكور والإناث مما يدل على قيم معنوية للعديد من المعلمات على سبيل المثال التلم الكلسي إلى القطب القذالي الأيمن والأيسر. كما أظهرت المقارنة بين الذكور والإناث نتائج ذات دلالة. الاستنتاجات: ستساعد هذه الدراسة في تحديد أو إجراء عملية جراحية من قبل جراحي الأعصاب في المناطق الوظيفية المهمة في الدماغ والتي تقع بالقرب من التلم حيث أن التلم متصل بوظائف الجهاز الجيري ويعمل كحاجز للتلافيف. Abstract: Objective: Sulci and gyri of the cerebrum can be easily identified with the aid of radiology but are difficult to locate during surgical operations, owing to anatomical variations and the surgical approach of the sulci through a small aperture. Therefore, this study was performed to locate the main sulci of the brain by using various anatomical landmarks in cadaveric brain specimens and CT scan images. Methods: In 31 cadaveric brain specimens (17 right and 14 left hemispheres) from people of unknown sex, 21 parameters associated with important sulci of the brain were studied. CT scan images for 150 patients in three age groups were examined. The patient IDs were categorized into 50 patients in each of the following age groups: 20–40 yr, 41–60 yr and 61–80 yr. Ten parameters were studied. The data were statistically analyzed in SPSS software. Results: In the cadaveric brain specimens, comparisons of right and left hemispheres indicated that only the posterior part of the calcarine sulcus showed a significant difference (p = 0.0394). In CT scans within each age group, comparison of the right and left sides in males and females showed significant differences for many parameters (e.g., calcarine sulcus to occipital pole: right p = 0.0025; left p = 0.0009). Comparisons between male and female parameters also showed significant differences. Conclusion: This study aids in identifying the important functional areas of the brain situated near the sulci, given that the sulci are connected to the gyral functions and act as a barrier for the gyri. The findings may facilitate neurosurgery operations.

The central sulcus is an important anatomical landmark the location of most of the anatomical structures and cortical lesions are described by their relation to the central sulcus [9,19]. During direct observation of the cerebral cortex, it is not always easy to understand the cortical anatomy of the sulci and gyri due to the presence of arachnoid matter. Furthermore, there often is anatomical variation in this region [13]. Therefore, this paper presents the crucial methods for identifying the central sulcus's exact anatomical location as it is critical for the neurosurgical team and to discuss its surgical implications. [ABSTRACT FROM AUTHOR]

The central sulcus is an important anatomical landmark the location of most of the anatomical structures and cortical lesions are described by their relation to the central sulcus [9,19]. During direct observation of the cerebral cortex, it is not always easy to understand the cortical anatomy of the sulci and gyri due to the presence of arachnoid matter. Furthermore, there often is anatomical variation in this region [13]. Therefore, this paper presents the crucial methods for identifying the central sulcus's exact anatomical location as it is critical for the neurosurgical team and to discuss its surgical implications.

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Background: Robert Wagner found a rare communication between precentral and postcentral sulcus in the right hemisphere of the brain of mathematician C.H. Fuch. He also documented right postcentral gyrus showing a bridge connecting it to posterior gyrus. Both these bridges are considered as bridge of Wagner. The aim of this study is to find the incidence and asymmetry of Wagner's bridge and to also determine morphometry of Rolandic fissure. Methodology: This is a descriptive study of 50 hemispheres from 25 formalin embalmed cadavers used for regular undergraduate classes to determine morphometry of Rolandic fissure and bridge of Wagner. Results: The length of Rolandic fissure was found more on the left side (10.49 cm). The depth of Rolandic fissure was found more in male hemispheres (1.52 cm). Interrupted precentral and postcentral sulcus was seen and a bridge of Wagner connecting the gyrus with adjacent gyrus was noted. Conclusion: Asymmetry was seen in the morphometry of the Central sulcus. A bridge of Wagner from pre and postcentral gyrus to adjacent gyrus anteriorly and posteriorly was seen. Knowledge of morphometry and bridge of Wagner will guide neurosurgeons during operative procedures.

Anatomic studies have suggested that the central insular sulcus (CIS) runs in line with the Rolandic sulcus (RS). The radiographic relationship between the RS and CIS has not been systematically studied. This study aims to evaluate the applicability of using the CIS as a radiologic landmark to identify the RS. We retrospectively reviewed 100 consecutive normal magnetic resonance imaging (MRI) scans (200 hemispheres) performed at a single institution. MRI scans with any intracranial pathology or finding were excluded. Sagittal and axial fluid-attenuated inversion recovery sequences were used in this study. Two evaluators independently evaluated the relationship of the CIS and RS in all MRI scans. A predefined 3-step method was then used to identify the CIS, RS, and hand motor area in sagittal and axial images. The CIS was found to be correlated with the RS in 191 hemispheres (95.5%). In the remaining 9 hemispheres, the postcentral sulcus represented the most correlated sulcus with the CIS (7 hemispheres). The interrater agreement was 0.673 (P < 0.05), indicating a substantial agreement. The hand motor area was identified in the same section as the CIS in 175 hemispheres (87.5%). The CIS is a highly reliable radiographic landmark for the identification of the RS. The hand motor area can also be identified reliably using this method. [ABSTRACT FROM AUTHOR]

Background: Cerebral hemisphere has outer gray matter and inner white matter. The cerebrum is folded into gyri and sulci in order to accommodate it in the skull. The thickness of the gray matter varies at sulci and gyri and the mean thickness may be from 1.5 mm to 4.0 mm. Aims and Objectives: (1) To demonstrate the cells and laminar architecture of the primary motor cortex with different stains. (2) To find out the age-related changes in the thickness of the primary motor cortex and the depth of the central sulcus. Materials and Methods: Cross-sectional study was done using 50 adult human brains and 10 fetal brains obtained from the Department of Forensic medicine and OBG, respectively, in a Government Medical College in Kerala during 2001–2003. At autopsy, the central sulcus and the precentral gyrus were identified. Depth of central sulcus and thickness of precentral gyrus, in upper, middle, and lower parts were measured using Vernier calipers. Tissue specimens were taken from the precentral gyrus and after fixation in 10% formalin, hematoxylin, and eosin-stained slides were prepared and viewed under a light microscope identifying six laminae. Using an oculo micrometer, width of the six laminae were measured. Pyramidal cells and stellate cells were observed and their size measured. Results: Depth of the central sulcus was more on the right side but it was minimal on the middle part of both sides. The thickness of the precentral gyrus varied from 1 to 6 mm. Maximum thickness of 6 mm was found in the middle and lower parts in the 21–30 age group. Lamina 5 was the widest of all laminae. Maximum width of 1000 μ was noted in the 41–50 age group. Conclusion: Grey matter thickness of 1-6 mm noted in this study was comparable with other studies. Pyramidal cells of varying sizes were seen in all sections with different staining methods. It was confirmed that neuronal loss is inevitable as age advances.

Purpose: The central sulcus is an important landmark in the brain. This study aimed to investigate the distinctive signal of the paracentral lobule (PL) on T1-weighted images (T1WIs; the white PL sign) and evaluate its usefulness as a new method of identifying the central sulcus. Methods: T1WIs of the brain of 96 participants (age, 58.9 ± 17.9 years; range, 8–87 years) scanned at 3-T MR system were retrospectively reviewed. First, we qualitatively analyzed the signal of the cortex of the PL by comparing it with that of the ipsilateral superior frontal gyrus on a 4-point grading score. Second, we compared the cortical signal intensity and gray/white-matter contrast between the PL and superior frontal gyrus. Third, we evaluated the usefulness of the PL signal for identifying the central sulcus. Results: The PL cortex was either mildly hyperintense (grade 2) or definitely hyperintense (grade 3) in comparison with that of superior frontal cortex in all participants. The signal intensity of the PL cortex was significantly higher than that of the superior frontal cortex (p < 0.001), whereas the gray/white-matter contrast of the PL was weaker than that of the superior frontal gyrus (p < 0.001). The central sulci were identified with 94.3% accuracy (181/192) using the new method. Conclusion: The white PL sign may be helpful in identifying the central sulcus, and this approach can be recognized as a new method for identification of the central sulcus. [ABSTRACT FROM AUTHOR]

The central sulcus divides the primary motor and somatosensory cortices in many anthropoid primate brains. Differences exist in the surface area and depth of the central sulcus along the dorso-ventral plane in great apes and humans compared to other primate species. Within hominid species, there are variations in the depth and aspect of their hand motor area, or knob, within the precentral gyrus. In this study, we used post-image analyses on magnetic resonance images to characterize the central sulcus shape of humans, chimpanzees (Pan troglodytes), gorillas (Gorilla gorilla), and orangutans (Pongo pygmaeus and Pongo abelii). Using these data, we examined the morphological variability of central sulcus in hominids, focusing on the hand region, a significant change in human evolution. We show that the central sulcus shape differs between great ape species, but all show similar variations in the location of their hand knob. However, the prevalence of the knob location along the dorso-ventral plane and lateralization differs between species and the presence of a second ventral motor knob seems to be unique to humans. Humans and orangutans exhibit the most similar and complex central sulcus shapes. However, their similarities may reflect divergent evolutionary processes related to selection for different positional and habitual locomotor functions., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: Cerebral hemisphere has outer gray matter and inner white matter. The cerebrum is folded into gyri and sulci in order to accommodate it in the skull. The thickness of the gray matter varies at sulci and gyri and the mean thickness may be from 1.5 mm to 4.0 mm. Aims and Objectives: (1) To demonstrate the cells and laminar architecture of the primary motor cortex with different stains. (2) To find out the age-related changes in the thickness of the primary motor cortex and the depth of the central sulcus. Materials and Methods: Cross-sectional study was done using 50 adult human brains and 10 fetal brains obtained from the Department of Forensic medicine and OBG, respectively, in a Government Medical College in Kerala during 2001-2003. At autopsy, the central sulcus and the precentral gyrus were identified. Depth of central sulcus and thickness of precentral gyrus, in upper, middle, and lower parts were measured using Vernier calipers. Tissue specimens were taken from the precentral gyrus and after fixation in 10% formalin, hematoxylin, and eosin-stained slides were prepared and viewed under a light microscope identifying six laminae. Using an oculo micrometer, width of the six laminae were measured. Pyramidal cells and stellate cells were observed and their size measured. Results: Depth of the central sulcus was more on the right side but it was minimal on the middle part of both sides. The thickness of the precentral gyrus varied from 1 to 6 mm. Maximum thickness of 6 mm was found in the middle and lower parts in the 21-30 age group. Lamina 5 was the widest of all laminae. Maximum width of 1000 µ was noted in the 41-50 age group. Conclusion: Grey matter thickness of 1-6 mm noted in this study was comparable with other studies. Pyramidal cells of varying sizes were seen in all sections with different staining methods. It was confirmed that neuronal loss is inevitable as age advances. [ABSTRACT FROM AUTHOR]

• The effects of stimulus polarity on MEP in bipolar cortical stimulation were examined. • Higher MEP was recorded with a cathode on the precentral and an anode on the postcentral gyrus. • The present results will contribute to a sensitive and specific MEP evaluation. The present study investigated the effects of the stimulus polarity and location of motor evoked potential (MEP) to establish a stimulation protocol. Nineteen patients who intraoperatively underwent MEP in bipolar direct cortical stimulation were enrolled in the present study. Somatosensory evoked potentials (SEP) of the contralateral median nerve stimulation were recorded to determine stimulation sites. MEP was performed under two settings in all patients: 1. Anodal bipolar stimulation: an anode on the precentral gyrus and a cathode on the postcentral gyrus, 2. Cathodal bipolar stimulation: a cathode on the precentral gyrus and an anode on the postcentral gyrus. MEP amplitudes and the coefficient of variation (CV) at a stimulation intensity of 25 mA and the thresholds of induced MEP were compared between the two settings. An electrical stimulation at 25 mA induced a significantly higher amplitude in cathodal bipolar stimulation than in anodal bipolar stimulation. Cathodal bipolar stimulation also showed significantly lower thresholds than anodal stimulation. CV did not significantly differ between the two groups. These results indicate that cathodal bipolar stimulation is superior to anodal bipolar stimulation for intraoperative MEP monitoring. MEP in cathodal bipolar cortical stimulation may be used in a safe and useful evaluation method of motor fiber damage that combines sensitivity and specificity. [ABSTRACT FROM AUTHOR]

The human brain grows rapidly in early childhood, reaching 95% of its final volume by age 6. Understanding brain growth in childhood is important both to answer neuroscience questions about anatomical changes in development, and as a comparison metric for neurological disorders. Metrics for neuroanatomical development including cortical measures pertaining to the sulci can be instrumental in early diagnosis, monitoring, and intervention for neurological diseases. In this paper, we examine the development of the central sulcus in children aged 12–60 months from structural magnetic resonance images. The central sulcus is one of the earliest sulci to develop at the fetal stage and is implicated in diseases such as Attention Deficit Hyperactive Disorder and Williams syndrome. We investigate the relationship between the changes in the depth of the central sulcus with respect to age. In our results, we observed a pattern of depth present early on, that had been previously observed in adults. Results also reveal the presence of a rightward depth asymmetry at 12 months of age at a location related to orofacial movements. That asymmetry disappears gradually, mostly between 12 and 24 months, and we suggest that it is related to the development of language skills. [ABSTRACT FROM AUTHOR]

There is a long-established link between anatomy and function in the somatomotor system in the mammalian cerebral cortex. The morphology of the central sulcus is predictive of the location of functional activation peaks relating to movement of different effectors in individuals. By contrast, morphological variation in the subcentral region and its relationship to function is, as yet, unknown. Investigating the subcentral region is particularly important in the context of speech, since control of the larynx during human speech production is related to activity in this region. Here, we examined the relationship between morphology in the central and subcentral region and the location of functional activity during movement of the hand, lips, tongue, and larynx at the individual participant level. We provide a systematic description of the sulcal patterns of the subcentral and adjacent opercular cortex, including the inter-individual variability in sulcal morphology. We show that, in the majority of participants, the anterior subcentral sulcus is not continuous, but consists of two distinct segments. A robust relationship between morphology of the central and subcentral sulcal segments and movement of different effectors is demonstrated. Inter-individual variability of underlying anatomy might thus explain previous inconsistent findings, in particular regarding the ventral larynx area in subcentral cortex. A surface registration based on sulcal labels indicated that such anatomical information can improve the alignment of functional data for group studies. [ABSTRACT FROM AUTHOR]

The central sulcus is probably one of the most studied folds in the human brain, owing to its clear relationship with primary sensory-motor functional areas. However, due to the difficulty of estimating the trajectories of the U-shape fibres from diffusion MRI, the short structural connectivity of this sulcus remains relatively unknown. In this context, we studied the spatial organization of these U-shape fibres along the central sulcus. Based on high quality diffusion MRI data of 100 right-handed subjects and state-of-the-art pre-processing pipeline, we first define a connectivity space that provides a comprehensive and continuous description of the short-range anatomical connectivity around the central sulcus at both the individual and group levels. We then infer the presence of five major U-shape fibre bundles at the group level in both hemispheres by applying unsupervised clustering in the connectivity space. We propose a quantitative investigation of their position and number of streamlines as a function of hemisphere, sex and functional scores such as handedness and manual dexterity. Main findings of this study are twofold: a description of U-shape short-range connectivity along the central sulcus at group level and the evidence of a significant relationship between the position of three hand related U-shape fibre bundles and the handedness score of subjects. [ABSTRACT FROM AUTHOR]

Cortical folding is a hallmark of brain topography whose variability across individuals remains a puzzle. In this paper, we call for an effort to improve our understanding of the pli de passage phenomenon, namely annectant gyri buried in the depth of the main sulci. We suggest that plis de passage could become an interesting benchmark for models of the cortical folding process. As an illustration, we speculate on the link between modern biological models of cortical folding and the development of the Pli de Passage Frontal Moyen (PPFM) in the middle of the central sulcus. For this purpose, we have detected nine interrupted central sulci in the Human Connectome Project dataset, which are used to explore the organization of the hand sensorimotor areas in this rare configuration of the PPFM. [ABSTRACT FROM AUTHOR]

Paradoxical cortical potential polarity of the upper extremity somatosensory evoked potential (SSEP) has been reported in cases of polymicrogyria (PMG) syndrome. To date, the pathophysiological basis of this electrophysiological aberration remains under investigation. Here we present a case of mild PMG that showed "layered" microgyri in the left frontoparietal cortices affecting both hand and foot sensorimotor areas. The SSEP recordings revealed an isolated polarity reversal of N20 from the dysplastic cortex. We postulate a central sulcus misfolding theory to explain the "positive" N20 potential recorded in the PMG cortex. [ABSTRACT FROM AUTHOR]

Introduction: The central sulcus is a key landmark on MRI of the brain, but its inferolateral portion is difficult to identify if unable to trace the sulcus superoinferiorly. The authors observed that the cortex abutting the central sulcus appears isointense to the adjacent white matter on DWI, we named this the 'invisible cortex sign' and our study evaluates whether it could be used to identify the inferolateral central sulcus.Methods: Observational study of 108 consecutive 'normal' MRI studies performed from May 2016 to January 2017. A single axial DWI image - obtained in the anterior commissure-posterior commissure plane - was selected from each scan just above the subcentral gyrus such that it included the most inferolateral portion of the central sulcus. These single images were given to 10 readers (neuroradiologists, a neuroradiology fellow and radiology trainees) who marked the central sulcus based on the presence of the 'invisible cortex sign'. Their accuracy in identifying the central sulcus was compared with that of the principal investigators, who used tri-planar T1 volumetric MRI sequences.Results: One hundred and eight consecutive patients (55 female, 53 male) were selected, ranging from 18 to 81 years old (mean = 40.5, σ = 18.2). The central sulcus was correctly identified in 95.5% of cases (σ = 3.7%; range 89.4-99.1%).Conclusion: The 'invisible cortex sign' is a highly accurate method of identifying the inferolateral central sulcus on a single axial DWI slice without relying on the more superior aspects of the sulcus. [ABSTRACT FROM AUTHOR]

Objective Individuals with autism spectrum disorder (ASD) often show characteristic differences in auditory processing. To clarify the mechanisms underlying communication impairment in ASD, we examined auditory language processing with both anatomical and functional methods. Methods We assessed the language abilities of adolescents with ASD and typically developing (TD) adolescents, and analyzed the surface-based morphometric structure between the groups using magnetic resonance imaging. Furthermore, we measured cortical responses to an auditory word comprehension task with magnetoencephalography and performed network-based statistics using the phase locking values. Results We observed no structural differences between the groups. However, the volume of the left ventral central sulcus (vCS) showed a significant correlation with linguistic scores in ASD. Moreover, adolescents with ASD showed weaker cortical activation in the left vCS and superior temporal sulcus. Furthermore, these regions showed differential correlations with linguistic scores between the groups. Moreover, the ASD group had an atypical gamma band (25–40 Hz) network centered on the left vCS. Conclusions Adolescents with ASD showed atypical responses on the auditory word comprehension task and functional brain differences. Significance Our results suggest that phonological processing and gamma band cortical activity play a critical role in auditory language processing-related pathophysiology in adolescents with ASD. [ABSTRACT FROM AUTHOR]