The microanatomy of the Sylvian fissure.

ABSTRACT

PURPOSE: Microsurgical anatomy of the Sylvian fissure is still a popular research topic for neurosurgeons. It is important for surgeons who perform skull base and Sylvian fissure surgical procedures to master the anatomy of the region. In our study, we aimed to review the current literature on the subject. METHODS: We reviewed the literature concerning the Sylvian fissure. In addition, we made a microdissection of four human cadaveric brains in order to take images of relevant anatomic structures. RESULTS: The Sylvian fissure includes both superficial and deep compartments. From the beginning of the surface structures and variable thickened subarachnoid membrane to the vascular structures located at the operculo-insular compartment, the surgical technique requires meticulous dissection in all stages of the surgery. CONCLUSIONS: From the view of neurosurgery, novel anatomical knowledge should enhance the success of the surgery. From the view of neuroscience, the Sylvian fissure and the Sylvian cistern have unique anatomical, vascular, and genotypical properties to the other areas of the cerebrum, making them complex and special.