Morphology of the lateral fossa of the brain (sylvian valley): anatomo-radiological aspects and surgical application

  • Racky WadeEmail author
  • Odile Plaisant
  • Alexis Guédon
  • Abdoulaye Dione Diop
  • Aïnina Ndiaye
  • Philippe Manyacka
  • Magaye Gaye
  • Sokhna Ba
  • Abdoulaye Ndiaye
  • Abdarahmane Dia
Original Article



The knowledge acquired on the lateral fossa of the brain (LFB) is heterogeneous and incomplete. Our goal was to provide a morphological description of the LFB and analyze the impact of these descriptions on the surgical approach of the region.


The morphology of LFB was studied on 40 cerebral hemispheres of 20 right-handed subjects aged 18–55 years with an MRI of 1.5 T. The anatomo-radiological identification of the two section levels preceded the description of the shapes of the LFB. From these landmarks, the forms presented by the LFB were identified and described on each of the transverse, sagittal and frontal planes. The comparison of the proportion of shapes made it possible to identify the typical shapes at each section level and on each section plane.


The average age of the subjects was 33 years with extremes of 19 and 54 years including 7 women and 13 right-handed men. According to the plane and the level of section, 6 typical morphologies of the LFB have been described, 2 of which were identical. The forms did not vary according to the cerebral hemisphere or the sex of the subject. The set of typical morphologies made it possible to determine a reference subject called NSK which presented the greatest number of typical morphological characteristics.


Knowledge of LFB anatomical imaging is of paramount importance in the pre-surgical evaluation of pathologies in this region. The reference subject will be used for our future biometric and three-dimensional manual reconstruction work in this region.


Lateral fossa of brain Sylvian valley Morphology Surgery MRI 



We thank all the staff of the Anatomy and Organogenesis laboratory of UCAD, the radiology department of CHNUF Fann, the ANCRE department of Paris Descartes-Sorbonne Paris Cité, for their availability and assistance. We also thank the Ministry of Higher Education, research and innovation of Senegal for its support through the PAPES (Project to support the Promotion of Researchers and Teachers of Senegal); Professor Sharon L. Juliano of IBRO for the correction of English and the officials of the Cooperation and Cultural Action Department of the French Embassy in Senegal who facilitated our second research visit to URDIA EA 4465.

Author contributions

RW, AN, OP, AD contributed to the development of the project. RW, ADD and SB are involved in data collection. RW, AN, PM and MG contributed to the data management. RW, AG and ADD analyzed the data. RW, AN, OP and AG participated in the writing of the manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interests.


  1. 1.
    Aboitiz F, Scheibel AB (1992) Morphometry of the sylvian fissure and corpus callasum, whith emphasis on sex differences. Brain 115:1521–1541CrossRefGoogle Scholar
  2. 2.
    Académie de médecine (2016) Fosse latérale du cerveau. In: Dictionnaire médical de l’Académie de Médecine. Accessed 13 Sept 2016
  3. 3.
    Afif A, Mertens P (2010) Description of sulcal organization of the insular cortex. Surg Radiol Anat 32:491–498CrossRefGoogle Scholar
  4. 4.
    Aydin IH, Kadioğlu HH, Tüzün Y, Kayaoğlu CR, Takci E (1996) The variations of sylvian veins and cisterns in anterior circulation aneurysms. Acta Neurochir 138(12):1380–1385CrossRefGoogle Scholar
  5. 5.
    Bakkum BW (2011) A historical lesson from Franciscus Sylvius and Jacobus Sylvius. J Chiropr Humanit 18:94–98CrossRefGoogle Scholar
  6. 6.
    Balak N (2014) The sylvian fissure, cistern and arachnoid membrane. Br J Neurosurg 28(1):98–106. CrossRefGoogle Scholar
  7. 7.
    Benet A, Hervey-Jumper SL, Sánchez JJG et al (2015) Surgical assessment of the insula. Part 1: surgical anatomy and morphometric analysis of the transsylvian and transcortical approaches to the insula. J Neurosurg 4:1–13. CrossRefGoogle Scholar
  8. 8.
    Broca M (2008) Lobe de l’insula. In: Chirurgie cérébraleGoogle Scholar
  9. 9.
    Collice M, Collice R, Riva A et al (2008) Who discovered the sylvian fissure? Neurosurgery 63(4):623–628CrossRefGoogle Scholar
  10. 10.
    Dejerine J, Dejerine-Klumpke A (1901) Anatomie des centres nerveux. Tome 2, Fascicule 1: Anatomie du cerveau (suite), anatomie du rhombencéphale. Accessed 4 Apr 2016
  11. 11.
    Dubret G, Cousin F-R (1985) Eléments d’Anatomie et de physiologie du système nerveux central. Flammarion, ParisGoogle Scholar
  12. 12.
    FitzGerald MJ, Folan-Curran J (2003) Neuro-anatomie clinique et neurosciences connexes. Maloine, ParisGoogle Scholar
  13. 13.
    Gibo H, Carver CC (1981) Microsurgical anatomy of the middle cerebral artery. J Neurosurg 54:151–169CrossRefGoogle Scholar
  14. 14.
    Gogolla N (2017) The insular cortex. Curr Biol 27:573–591CrossRefGoogle Scholar
  15. 15.
    Kamina P (2013) Neuroanatomie, 2th edn. Maloine, ParisGoogle Scholar
  16. 16.
    Kazumata K, Kamiyama H, Ishikawa T, Takizawa K, Maeda T, Makino K et al (2003) Operative anatomy and classification of the sylvian veins for the distal transsylvian approach. Neurol Med Chir 43(9):427–433CrossRefGoogle Scholar
  17. 17.
    Maslehaty H, Cornelius D (2017) Computed tomography- and magnetic resonance image-based analysis of the anatomical variations of the sylvian fissure and characteristics of the middle cerebral artery. Clin Pract 7:890CrossRefGoogle Scholar
  18. 18.
    Ngando HM (2013) Anatomical configuration of the sylvian fissure and its influence on outcome after pterional approach for microsurgical aneurysm clipping. Surg Neurol Int 4:129Google Scholar
  19. 19.
    Nieuwenhuys R, Voogd J, Van Huijzen C (2008) Telencephalon: neocortex. In: The human central nervous system, 4th edn. Springer, BerlinCrossRefGoogle Scholar
  20. 20.
    Park HW, Chung SY (2013) Two indices affecting the directions of the sylvian fissure dissection in middle cerebral artery bifurcation aneurysms. J Cerebrovasc Endovasc Neurosurg 15:164CrossRefGoogle Scholar
  21. 21.
    Plaisant O et al (2016) Dejerine atlas. Accessed 5 Sept 2018
  22. 22.
    Rahmah NN, Murata T, Yako T, Horiuchi T, Hongo K (2011) Correlation between squamous suture and sylvian fissure: osirix DICOM viewer study. Plosone 6(3):181–199CrossRefGoogle Scholar
  23. 23.
    Rouvière H, Delmas A, révisée par Delmas V (1997) Système nerveux central. In: Anatomie humaine: descriptive, topographique et fonctionnelle. Tome III Membres, Système nerveux central. Masson, ParisGoogle Scholar
  24. 24.
    Rouvière H, Delmas A (2002) Système nerveux central, voies et centres nerveux. In: Anatomie humaine. Descriptive, topographique et fonctionnelle, 15th edn. Revised by Delmas V. Masson, ParisGoogle Scholar
  25. 25.
    Safaee MM, Englot DJ (2016) The transsylvian approach for resection of insular gliomas: technical nuances of splitting the sylvian fissure. J Neuro 130:238–287Google Scholar
  26. 26.
    Sanai N, Polley M-Y (2010) Insular glioma resection: assessment of patient morbidity, survival, and tumor progression. J Neurosurg 112:1–9CrossRefGoogle Scholar
  27. 27.
    Sharma TR, Riddle LC (2012) “I can hear the noise, but not the voice”—a case of bilateral sylvian fissure infarct in a 52-year-old man. Prim Care Companion CNS Disord 14(1):11l0–1159Google Scholar
  28. 28.
    Tanriover N, Rhothon AC, Kawashima M et al (2004) Microsurgical anatomy of the insula and the sylvian fissure. J Neurosurg 100:891–922CrossRefGoogle Scholar
  29. 29.
    Varnavas GG, Grant W (1999) The insular cortex: morphological and vascular anatomic characteristics. Neurosurgery 44(1):127–136CrossRefGoogle Scholar
  30. 30.
    Vitte E, Chevallier J-M (1998) Neuro-anatomie, 4th edn. Flammarion, ParisGoogle Scholar
  31. 31.
    Wen HT, Rhoton AL, De Oliveira E et al (2009) Microsurgical anatomy of the temporal lobe: part 2—sylvian fissure region and its clinical application. Neurosurg Online (65):1–36Google Scholar
  32. 32.
    Yasargil MG, Kasdaglis K, Jain KK, Weber HP (1976) Anatomical observations of the subarachnoid cisterns of the brain during surgery. J Neurosurg 44(3):298–302CrossRefGoogle Scholar

Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  • Racky Wade
    • 1
    • 2
    Email author
  • Odile Plaisant
    • 2
  • Alexis Guédon
    • 2
  • Abdoulaye Dione Diop
    • 3
  • Aïnina Ndiaye
    • 1
  • Philippe Manyacka
    • 4
  • Magaye Gaye
    • 1
  • Sokhna Ba
    • 3
  • Abdoulaye Ndiaye
    • 1
  • Abdarahmane Dia
    • 1
  1. 1.Laboratory of Anatomy and Organogenesis, Faculty of Medicine, Pharmacy and StomatologyCheikh Anta Diop UniversityDakarSenegal
  2. 2.Research Unit for the Development of Anatomy and Imaging (URDIA) EA 4465, Department of Numerical, Surgical, Radiological and Experimental AnatomyParis Descartes-Sorbonne Paris Cité UniversityParisFrance
  3. 3.Diagnostic and Medical Imaging CenterFann National University Hospital CenterDakarSenegal
  4. 4.Laboratory of Anatomy and Organogenesis, UFR 2SGaston Berger UniversitySaint-LouisSenegal

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