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Vol. 25. Issue 6.
Pages 268-274 (November - December 2014)
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Vol. 25. Issue 6.
Pages 268-274 (November - December 2014)
Artículo de revisión
Fascículos asociativos ínsulo-operculares: revisión de su anatomía y de las implicaciones para el abordaje transopercular a la ínsula
Insular-opercular associative tracts: Review of their anatomy and relevance for the trans-opercular approach to the insula
Carlos Buchelia, David Matoa, Enrique Marco de Lucasb, Juan A. García-Porreroc, Alfonso Vázquez-Barqueroa, Juan Martinoa,
Corresponding author
juan.martino@hotmail.com

Autor para correspondencia.
a Departamento de Neurocirugía, Hospital Universitario Marqués de Valdecilla, Fundación Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Cantabria, España
b Departamento de Radiología, Hospital Universitario Marqués de Valdecilla, Fundación Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Cantabria, España
c Departamento de Anatomía y Bilogía Celular, Universidad de Cantabria, Santander, Cantabria, España
Article information
Abstract
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Resumen
Introducción

No hay estudios que revisen en detalle y de forma sistemática la anatomía de los fascículos asociativos ínsulo-operculares.

Objetivo

En el presente trabajo, se realizó una extensa revisión de la literatura reciente de las fibras de asociación relacionadas con el lóbulo de la ínsula y los opérculos.

Resultados

Los tractos conectados con los opérculos son el fascículo frontal oblicuo, el fascículo arcuato, la porción horizontal del fascículo longitudinal superior y el fascículo longitudinal medial. A nivel de la ínsula, el fascículo fronto-occipital inferior (FFOI) discurre paralelo al fascículo uncinado, atravesando la porción antero-inferior de la cápsula externa y el claustrum.

Conclusiones

La pars triangular y orbicular de la circunvolución frontal inferior y la parte media y anterior de la circunvolución temporal superior están menos conectadas con la red perisilviana asociativa. De esta forma, constituyen 2 corredores anatómicos para el abordaje transopercular a la ínsula.

Palabras clave:
Disección de fibras
Estimulación eléctrica intraoperatoria
Ínsula
Tractografía por tensor de difusión
Sustancia blanca cerebral
Abstract
Introduction

The insula is a highly connected area, as an intricate network of afferent and efferent projections connect it with adjacent and distant cortical regions.

Objective

To perform an extensive review of recent literature to analyse the anatomy of the associative tracts related to the insula.

Results

The frontal aslant tract, arcuate fasciculus, horizontal portion of the superior longitudinal fasciculus and the middle longitudinal fasciculus are associative tracts connected to the opercula. The inferior fronto-occipital fasciculus (IFOF) and uncinate fasciculus run under the anterior and inferior portion of the insula.

Conclusions

the pars triangularis and orbicularis of the inferior frontal gyrus, as well as the middle and anterior part of the superior temporal gyrus, have few connections with the perisylvian associative network. Consequently, in the trans-opercular approach to the insula, these 2 regions represent anatomical corridors that give access to the insula. The IFOF and the uncinate fasciculus represent the deep functional margin of resection.

Keywords:
Fiber dissection
Intraoperative electrical stimulation
Insula
Diffusion tensor imaging tractography
White matter

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