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Copyright of Surgical & Radiologic Anatomy is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The precise sulcogyral localization of cortical lesions is mandatory to improve communication between practitioners and to predict and prevent post-operative deficits. This process, which assumes a good knowledge of the cortex anatomy and a systematic analysis of images, is, nevertheless, sometimes neglected in the neurological and neurosurgical training. This didactic paper proposes a brief overview of the sulcogyral anatomy, using conventional MR-slices, and also reconstructions of the cortical surface after a more or less extended inflation process. This method simplifies the cortical anatomy by removing part of the cortical complexity induced by the folding process, and makes it more understandable. We then reviewed several methods for localizing cortical structures, and proposed a three-step identification: after localizing the lateral, medial or ventro-basal aspect of the hemisphere (step 1), the main interlobar sulci were located to limit the lobes (step 2). Finally, intralobar sulci and gyri were identified (step 3) thanks to the same set of rules. This paper does not propose any new identification method but should be regarded as a set of practical guidelines, useful in daily clinical practice, for detecting the main sulci and gyri of the human cortex.

Background: This study aimed to have international experts converge on a harmonized definition of whole hippocampus boundaries and segmentation procedures, to define standard operating procedures for magnetic resonance (MR)-based manual hippocampal segmentation., Methods: The panel received a questionnaire regarding whole hippocampus boundaries and segmentation procedures. Quantitative information was supplied to allow evidence-based answers. A recursive and anonymous Delphi procedure was used to achieve convergence. Significance of agreement among panelists was assessed by exact probability on Fisher's and binomial tests., Results: Agreement was significant on the inclusion of alveus/fimbria (P = .021), whole hippocampal tail (P = .013), medial border of the body according to visible morphology (P = .0006), and on this combined set of features (P = .001). This definition captures 100% of hippocampal tissue, 100% of Alzheimer's disease-related atrophy, and demonstrated good reliability on preliminary intrarater (0.98) and inter-rater (0.94) estimates., Discussion: Consensus was achieved among international experts with respect to hippocampal segmentation using MR resulting in a harmonized segmentation protocol., (Copyright © 2015 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.)

Objective: The pathologic validation of European Alzheimer's Disease Consortium Alzheimer's Disease Neuroimaging Initiative Center Harmonized Hippocampal Segmentation Protocol (HarP)., Methods: Temporal lobes of nine Alzheimer's disease (AD) and seven cognitively normal subjects were scanned post-mortem at 7 Tesla. Hippocampal volumes were obtained with HarP. Six-micrometer-thick hippocampal slices were stained for amyloid beta (Aβ), tau, and cresyl violet. Hippocampal subfields were manually traced. Neuronal counts, Aβ, and tau burden for each hippocampal subfield were obtained., Results: We found significant correlations between hippocampal volume and Braak and Braak staging (ρ = -0.75, P = .001), tau (ρ = -0.53, P = .034), Aβ burden (ρ = -0.61, P = .012), and neuronal count (ρ = 0.77, P < .001). Exploratory subfield-wise significant associations were found for Aβ in Cornu Ammonis (CA)1 (ρ = -0.58, P = .019) and subiculum (ρ = -0.75, P = .001), tau in CA2 (ρ = -0.59, P = .016), and CA3 (ρ = -0.5, P = .047), and neuronal count in CA1 (ρ = 0.55, P = .028), CA3 (ρ = 0.65, P = .006), and CA4 (ρ = 0.76, P = .001)., Conclusions: The observed associations provide pathological confirmation of hippocampal morphometry as a valid biomarker for AD and pathologic validation of HarP., (Copyright © 2015 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.)

Background: An international Delphi panel has defined a harmonized protocol (HarP) for the manual segmentation of the hippocampus on MR. The aim of this study is to study the concurrent validity of the HarP toward local protocols, and its major sources of variance., Methods: Fourteen tracers segmented 10 Alzheimer's Disease Neuroimaging Initiative (ADNI) cases scanned at 1.5 T and 3T following local protocols, qualified for segmentation based on the HarP through a standard web-platform and resegmented following the HarP. The five most accurate tracers followed the HarP to segment 15 ADNI cases acquired at three time points on both 1.5 T and 3T., Results: The agreement among tracers was relatively low with the local protocols (absolute left/right ICC 0.44/0.43) and much higher with the HarP (absolute left/right ICC 0.88/0.89). On the larger set of 15 cases, the HarP agreement within (left/right ICC range: 0.94/0.95 to 0.99/0.99) and among tracers (left/right ICC range: 0.89/0.90) was very high. The volume variance due to different tracers was 0.9% of the total, comparing favorably to variance due to scanner manufacturer (1.2), atrophy rates (3.5), hemispheric asymmetry (3.7), field strength (4.4), and significantly smaller than the variance due to atrophy (33.5%, P < .001), and physiological variability (49.2%, P < .001)., Conclusions: The HarP has high measurement stability compared with local segmentation protocols, and good reproducibility within and among human tracers. Hippocampi segmented with the HarP can be used as a reference for the qualification of human tracers and automated segmentation algorithms., (Copyright © 2015 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.)

Branching patterns of microvascular networks influence vascular resistance and allow control of peripheral flow distribution. The aim of this paper was to analyze these branching patterns in human cerebral cortex. Digital three-dimensional images of the microvascular network were obtained from thick sections of India ink-injected human brain by confocal laser microscopy covering a large zone of secondary cortex. A novel segmentation method was used to extract the skeletons of 228 vascular trees (152 arterioles and 76 venules) and measure the diameter at every vertex. The branching patterns (area ratios and angles of bifurcations) of nearly 10,000 bifurcations of cortical vascular trees were analyzed, establishing their statistical properties and structural variations as a function of the vessel nature (arterioles versus venules), the parent vessel topological order or the bifurcation type. We also describe their connectivity and discuss the relevance of the assumed optimal design of vascular branching to account for the complex nature of microvascular architecture. The functional implications of some of these structural variations are considered. The branching patterns established from a large database of a human organ contributes to a better understanding of the bifurcation design and provides an essential reference both for diagnosis and for a future large reconstruction of cerebral microvascular network., (Copyright 2009 Elsevier B.V. All rights reserved.)

Objective: Vascular architecture, particularly of cerebral microvessels, has profound implications for both health and disease in a variety of areas, such as neuroimaging, angiogenesis and development, Alzheimer's disease, and vascular tumors. We analyzed the architecture of tree-like vessels of the human cerebral cortex., Methods: Digital three-dimensional images of the microvascular network were obtained from thick sections of India ink-injected human brain by confocal laser microscopy covering a large zone of secondary cortex. A novel segmentation method was used to extract the skeleton and measure the diameter at every vertex., Results: In this paper, we focus on the topology of the cortical tree-like vessels. Using stem-crown decomposition, power-scaling laws were shown to govern the relationships between integrated parameters, such as the distal cumulative length, volume, or normalized flow. This led us toward an experimental confirmation of the allometric equation between mass and metabolic rate. Inversely, the power-law model did not match the relationships between local parameters, such as diameter, and integrated ones. As a consequence, Murray's law did not appropriately model the architecture of cerebrovascular bifurcations., Conclusions: This study provides a unique, large database and mathematical characterization that may prove valuable for modeling the cerebral.

Studies on human brain microcirculation have thus far yielded few quantitative data, preventing the closest possible interpretation of functional imaging methods such as fMRI and PET that necessarily rely on robustly delineated morphology of haemodynamic systems. Inadequate data in this area can lead to severe underestimation of the spatial specificity of the BOLD response. We took thick sections of Indian ink injected human brain and, using confocal laser microscopy and a novel three-dimensional computer-assisted method we extracted and analyzed hundreds of thousands of vascular segments within a large area of cortex. From this database the global densities, the statistical distributions of diameters and lengths were analysed, separating the tree-like and the net-like parts of the microcirculation. Furthermore, our analysis included variations in volume density along the cortical depth and along vectors parallel to the cortical surface. These morphometric parameters are all key requirements for a sound model of cerebral microcirculation.

After a short overview of the history of our knowledge of the pineal gland, its anatomy and its function, this work is primarily devoted to the relationships of the pineal gland to the nerve structures which delineate the pineal region. The complex surrounding blood vessels located in the quadrigeminal cistern are described with a special focus on the numerous venous trunks. Finally, the pineal blood supply is studied in three steps: (1) The arterial supply obtained through several groups of pineal arteries stemming mainly from the medial posterior choroidal arteries; (2) The venous drainage by the lateral pineal veins flowing, in most cases, into the cerebral vein of Galen; (3) The intrapineal vascular architecture with specific features concerning the central part of the gland highly vascularized by large sinusoid capillaries and its peripheral part poorly vascularized by small and fine blood vessels.

Three levels are described for the study of cortical blood vessels: the main leptomeningeal arteries and veins, the fine pial network and the intracortical vessels. If the main leptomeningeal arteries and veins are well known, the functional anatomy of the fine cortical blood supply is still obscure. Pial arteries and veins form a dense superficial network. The anastomoses between arteries and between veins are numerous but no arteriovenous anastomoses were found. Numerous smooth vascular formations are suspected into the vascular walls and would regulate the pial (and intracortical) blood flow. The intracortical network is divided into arteries, veins and capillaries. Five types of arteries and veins are described according to their degree of intracortical penetration. The capillary network may be described into four layers according to their density. The lay-out of arteries and veins and their branching would allow to suspect three types of intracortical flows. Intracortical vascular units were also described each composed of a central vein surrounded by peripheral arteries. No arterial or venous anastomoses were found in the cortex whereas precapillary arteriovenous shunts would be suspected. Vascular deformities may be due to aging, are present in the cortex and in the subcortical region.

The development of neuroimaging has allowed clinicians to improve clinicoanatomic correlations in patients with stroke. Anatomic structures are well delineated on MRI, but there is a lack of standardization in their arterial supply. As in our previous study depicting the arterial supply of the brainstem and cerebellum, we present a system of 12 axial sections of the hemispheres depicting the dominant arterial territories, the most important anatomic structures, and Brodmann's areas. The area of variation of the cortical territory of the anterior, middle, and posterior cerebral arteries is also represented. These sections may be used as a practical tool to determine arterial territories on CT or MRI, and may help establish consistent clinicoanatomic correlations in patients with supratentorial stroke.

The development of neuroimaging has allowed clinicians to improve clinicoanatomic correlations in patients with strokes. Brainstem and cerebellum structures are well delineated on MRI, but there is a lack of standardization in their arterial supply. We present a system of 12 brainstem and cerebellum axial sections, depicting the dominant arterial territories and the most important anatomic structures. These sections may be used as a practical tool to determine arterial territories on MRI, and may help establish consistent clinicoanatomic correlations in patients with brainstem and cerebellar ischemic strokes.

Ten AIDS patients with Kaposi's sarcoma (four in stage II A, four in stage III A, one in stage III B and one in stage IV of the disease) were treated for 14 days with B-E8, an anti-IL-6 monoclonal antibody (IgG1), at a daily dose of 10 mg. No side-effects were observed, but no patients experienced a complete or partial response. No modification was noted in the analysis of lymphocyte subsets, except for a transient decline in the number of cells expressing CD56, accompanied by altered NK activity in four of the seven evaluable patients. Anti-IL-6 mAb prevented the binding of IL-6 to its cell membrane receptor, as documented by the decline in C reactive protein levels. However, anti-IL-6 mAb induced the circulation of significant amounts of IL-6, probably in the form of monomeric immune complexes. The sera, analysed on B9 cell line, demonstrated a stimulating activity, indicating that hypersensitive cells were able to cleave these complexes. This observation, together with the clinical inefficacy of the treatment, should prompt us to be careful with the use of unmanipulated single monoclonal antibodies, especially in cancer patients.

Following a brief review of embryogenesis and phylogenesis, the different anatomical structures of the temporal lobe of the brain are described. This lobe has 4 surfaces: lateral, inferomedial, superomedial and superior. The first 2 surfaces, visible on the lateral and inferior aspects of the cerebral hemisphere, are composed of 5 temporal gyri. The superomedial and superior surfaces do not show and must be made visible by a digital or instrumental manipulation. The hippocampal formation, surrounded by the temporal horn of the lateral ventricle medially, the choroid and transverse fissures laterally and the amygdaloid complex anteriorly, forms the superomedial surface and represents the "rhincendephalic" part of the temporal lobe. The superolateral surface, which is the superior surface of the first temporal gyrus, is buried deeply in the fissure of Sylvius and is divided into 3 parts: the planum polare, the gyri of Heschl and the planum temporale. Two categories of fibres are present in the white matter of the temporal lobe: projection fibres (acoustic radiation, optic radiation, temporo-pontine tract, temporo-thalamic fasciculus) and association fibres (cingulum, anterior longitudinal, uncinate, superior occipitofrontal, superior longitudinal fasciculi). The anatomical temporal lobe exploration by MRI was carried out with inversion-recovery sequences performed in all three dimensions. The authors describe the advantages and limitations of MRI and indicate the most appropriate plane(s) for the study of the various temporal structures, with emphasis on coronal on coronal and sagittal sections.

This study is divided in two parts: a. the cerebral cortical vessels: pial arteries and veins at the gyrus surface are described as well as their anastomoses. Intracortical arteries and veins are divided into 5 groups according to their degree of cortical penetration. A correlation between cytoarchitecture and angioarchitecture is established. b. The cerebellar cortical vessels: they are compared to the cerebral vessels. The vascularization of Purkinje cells is especially described: the Purkinje cells are in close contact with an arterial network which is situated parallel to the cortical surface; it is probable that the nutrition of the Purkinje cells is obtained through the wall of this parallel arterial network.

The study is divided into two parts. (a) Superficial or pial vessels: Arterioles and venules at the gyrus surface as well as their mode of penetration into or emergence from nervous tissue is described. The absence of pial capillaries is noted. Arterial and venous anastomoses are described whereas arteriovenous anastomoses were not encountered. In particular, the relationship of superficial vessels to the arachnoid was studied. (b) Intracortical vessels: Arteries and veins were divided into 5 groups according to their degree of cortical penetration. Considering its density, the vascular network of the cortex was divided into 4 vascular layers. A correlation between these layers and the cellular layers was established. Problems in distinguishing between arteries and veins, the geometric disposition of cortical vessels, different types of anastomoses and particular vascular features whose significance remains unclear, are discussed.