title: Three-Dimensional Anatomy of the White Matter Fibers of the Temporal Lobe: Surgical Implications.
abstract: BACKGROUND
  The aim of this work is to describe in detail the complex 3-dimensional organization of the white matter of the temporal lobe and discuss the surgical implications of the approaches to lesions located into the mesial temporal region and within the temporal horn and the atrium of the lateral ventricles.
  
  
  METHODS
  Sixteen human cerebral hemispheres fixed in a 10% formalin solution for at least 40 days were studied. After removal of the arachnoid membrane, the hemispheres were frozen at -15°C for at least 14 days, and the Klingler technique, which consists of the microscopic dissection and progressive identification of white matter fibers, was performed.
  
  
  RESULTS
  The dissection allowed us to appreciate the topographical organization of the white matter of the temporal lobe identifying the most important association, projection, and commissural fasciculi. The dissection from the lateral side allowed the progressive visualization of the superior longitudinal fasciculus and its components, the extreme and external capsule, the uncinate fasciculus, the inferior fronto-occipital fasciculus, the anterior commissure, the internal capsule, and the optic radiations. The dissection was completed from the inferior and medial side for identification of the cingulum and the fornix.
  
  
  CONCLUSIONS
  The complex 3-dimensional organization of the white matter substance of the temporal lobe is characterized by 2 main systems of boundaries: the sagittal stratum and the temporal stem. Their knowledge is essential for the appropriate treatment of pathologies localized in this region as demonstrated by the 2 clinical cases presented in this work.
authors.affiliation: Department of Neurosurgery, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Pescatori
authors.affiliation: Department of Neurosurgery, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy. Electronic address: mariapia.tropeano@libero.it.
authors.forename: Maria Pia
authors.initials: MP
authors.lastname: Tropeano
authors.affiliation: Department of Neurosurgery, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Manfreda
authors.affiliation: Department of Neurosurgery, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Delfini
authors.affiliation: Department of Neurosurgery, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Santoro
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002533:Cerebral Angiography; D015925:Cryopreservation; D004210:Dissection; D005260:Female; D005404:Fixatives; D005557:Formaldehyde; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008297:Male; D008579:Meningioma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D009413:Nerve Fibers, Myelinated; D019635:Neurosurgical Procedures / Q000379:methods; D013702:Temporal Lobe / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D016707:Tissue Fixation; D014057:Tomography, X-Ray Computed; D066127:White Matter / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery
chemical_list: D005404:Fixatives; D005557:Formaldehyde
keywords: Extreme capsule; Internal capsule; Meyer loop; Superior longitudinal fasciculus; Temporal lobe; Three-dimensional anatomy; White matter