title: [Surgical anatomy of the peri-insular association tracts. Part I.The superior longitudinal fascicle system].
abstract: OBJECTIVE
  To study the peri-insular association tract anatomy and define the permissible anatomical boundaries for resection of glial insular tumors with allowance for the surgical anatomy of the peri-insular association tracts.
  
  
  METHODS
  In an anatomic study of the superior longitudinal fascicle system (SLF I, SLF II, SLF III, arcuate fascicle), we used 12 anatomical specimens (6 left and 6 right hemispheres) prepared according to the Klingler's fiber dissection technique. To confirm the dissection data, we used MR tractography (HARDI-CSD-tractography) of the conduction tracts, which was performed in two healthy volunteers.
  
  
  RESULTS
  Except the SLF I (identified in 7 hemispheres by fiber dissection), all fascicles of the SLF system were found in all investigated hemispheres by both fiber dissection and MR tractography. The transcortical approach to the insula through the frontal and (or) parietal operculum is associated with a significant risk of transverse transection of the SLF III fibers passing in the frontal and parietal opercula. The most optimal area for the transcortical approach to the insula is the anterior third of the superior temporal gyrus that lacks important association tracts and, consequently, a risk of their injury. The superior peri-insular sulcus is an intraoperative landmark for the transsylvian approach, which enables identification of the SLF II and arcuate fascicle in the surgical wound.
  
  
  CONCLUSIONS
  Detailed knowledge of the peri-insular association tract anatomy is the prerequisite for neurosurgery in the insular region. Our findings facilitate correct identification of both the site for cerebral operculum dissection upon the transcortical approach and the intraoperative landmarks for locating the association tracts in the surgical wound upon the transsylvian approach to the insula.
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: A E
authors.initials: AE
authors.lastname: Bykanov
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: D I
authors.initials: DI
authors.lastname: Pitskhelauri
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: A I
authors.initials: AI
authors.lastname: Batalov
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: I N
authors.initials: IN
authors.lastname: Pronin
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: M A
authors.initials: MA
authors.lastname: Shkarubo
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: G F
authors.initials: GF
authors.lastname: Dobrovol'sky
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: G L
authors.initials: GL
authors.lastname: Kobyakov
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: S B
authors.initials: SB
authors.lastname: Buklina
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: V L
authors.initials: VL
authors.lastname: Puchkov
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: N E
authors.initials: NE
authors.lastname: Zakharova
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: A S
authors.initials: AS
authors.lastname: Smirnov
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: A Z
authors.initials: AZ
authors.lastname: Sanikidze
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: D A
authors.initials: DA
authors.lastname: Gol'bin
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: E L
authors.initials: EL
authors.lastname: Pogosbekyan
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: E S
authors.initials: ES
authors.lastname: Kudieva
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: A M
authors.initials: AM
authors.lastname: Shkatova
authors.affiliation: Burdenko Neurosurgical Institute, Moscow, Russia.
authors.forename: A A
authors.initials: AA
authors.lastname: Potapov
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016548:Prosencephalon / Q000033:anatomy & histology* / Q000601:surgery*