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Microsurgical Anatomy of the Anterior Commissure: Correlations With Diffusion Tensor Imaging Fiber Tracking and Clinical Relevance

Peltier, Johann MD, PhD*; Verclytte, Sébastien MD, PhD; Delmaire, Christine MD, PhD; Pruvo, Jean-Pierre MD, PhD; Havet, Eric MD, PhD*; Le Gars, Daniel MD, PhD*

doi: 10.1227/NEU.0b013e31821bc822
Surgical Anatomy and Technique: Editor's Choice
Editor's Choice

BACKGROUND: Detailed anatomy of the anterior commissure is unknown in the literature.

OBJECTIVE: To describe the anterior commissure with the use of a fiber dissection technique by focusing on the morphology (length and breadth of the 2 portions), the course, and the relations with neighboring fasciculi, particularly in the temporal stem.

METHODS: We dissected 8 previously frozen, formalin-fixed human brains under the operating microscope using the fiber dissection described by Klingler. Lateral, inferior, and medial approaches were made.

RESULTS: The anterior olfactive limb of the anterior commissure was sometimes absent during dissection. The cross-sectional 3-dimensional magnetic resonance rendering images showed that fibers of the anterior commissure curved laterally within the basal forebrain. The tip of the temporal limb of the anterior commissure was intermingled with other fasciculi in various directions to form a dense 3-dimensional network.

CONCLUSION: Functional anatomy and comparative anatomy are described. The anterior commissure can be involved in various pathologies such as diffuse axonal injury, schizophrenia, and cerebral tumoral dissemination.

*Laboratoire d'Anatomie et d'Organogenèse, Université de Picardie Jules Verne, Amiens, France

Service de Neuroradiologie, CHRU Lille, France

Correspondence: Johann Peltier, MD, PhD, Service de Neurochirurgie, Centre Hospitalier, Universitaire d'Amiens, Place Victor Pauchet, 80054 Amiens Cedex 1, France. E-mail: peltier.johann@chu-amiens.fr

Received November 1, 2010

Accepted February 22, 2011

Copyright © by the Congress of Neurological Surgeons