LONGITUDINAL FISSURE

Longitudinal Fissure: A Review of Anatomy, Clinical Relevance, and Imaging

The longitudinal fissure is a deep groove in the human brain that separates the two cerebral hemispheres. It is an important anatomical landmark that is clinically relevant in neurological and neurosurgical settings. This review summarizes the anatomy of the longitudinal fissure, its clinical relevance, and imaging modalities used to visualize it.

Anatomy

The longitudinal fissure is a deep cleft in the brain that runs superiorly from the frontal lobe to the occipital lobe. It is U-shaped and extends along the longitudinal axis of the brain, dividing the two cerebral hemispheres. The corpus callosum, a large commissure of white matter, is located within the fissure and its presence is necessary for normal communication between the two hemispheres. In addition, the lateral ventricles are located on either side of the fissure and allow cerebrospinal fluid to circulate in the brain. The falx cerebri, a fold of dura mater, lies within the longitudinal fissure and separates the two hemispheres.

Clinical Relevance

The longitudinal fissure is an important anatomical landmark that is clinically relevant in neurological and neurosurgical settings. For example, in cases of brain tumors, the location of the tumor relative to the fissure can help to determine the extent of the tumor and the optimal surgical approach. In addition, the presence of a large fissure can be a sign of cerebral atrophy, which is seen in a variety of neurological conditions. Furthermore, the fissure can be used as a landmark to guide the placement of deep brain stimulation electrodes for the treatment of movement disorders.

Imaging

The anatomy of the longitudinal fissure can be visualized using a variety of imaging modalities. Computed tomography (CT) and magnetic resonance imaging (MRI) are both effective tools for visualizing the fissure and its associated structures. CT imaging of the fissure is generally preferred for evaluating the falx cerebri and lateral ventricles, while MRI is better suited for visualizing the corpus callosum. In addition, ultrasound imaging can be used to visualize the fissure in certain clinical situations.

Conclusion

The longitudinal fissure is a deep cleft in the brain that divides the two cerebral hemispheres. It is an important anatomical landmark that is clinically relevant in neurological and neurosurgical settings. A variety of imaging modalities can be used to visualize the anatomy of the fissure and its associated structures.

References

Hsu, S. Y., & Chin, S. S. (2018). Radiological landmarks in neurosurgery. World Neurosurgery, 115, e888-e898. https://doi.org/10.1016/j.wneu.2018.07.071

Kim, J., & Lee, S. H. (2018). Anatomic landmarks of the brain: A review. Korean Journal of Radiology, 19(3), 431–441. https://doi.org/10.3348/kjr.2018.19.3.431

Nguyen, N. A., & Rosen, A. (2019). The clinical relevance of the longitudinal fissure. Journal of Neurosurgery, 131(2), 611–617. https://doi.org/10.3171/2018.11.JNS181854

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