Introduction: The anatomical structures of the parietal lobe at the cortical and subcortical levels are related mainly to sensory, visuospatial, visual and language function. The aim of this study was to present an intraoperative perspective of these critical structures in terms of the surgical treatment of intra-axial lesions. The study also discusses the results of the technique and the results of direct brain stimulation under awake conditions. Materials and Methods: Five adult brains were prepared according to the Klingler technique. Cortical assessments and all measurements were performed with the naked eye, while white matter dissection was performed with microscopic magnification. Results: Intra-axial lesions within the parietal lobe can be approached through a lateral or superior trajectory. This decision is based on the location of the lesions in relation to the arcuate fascicle/superior longitudinal fascicle (AF/SLF) complex and ventricular system. Regardless of the approach, the functional borders of the resection are defined by the postcentral gyrus anteriorly and Wernicke's speech area inferiorly. On the subcortical level, active identification of the AF/SLF complex and of the optic radiation within the sagittal stratum should be performed. The intraparietal sulcus (IPS) is a reliable landmark for the AF/SLF complex in ~60% of cases. Conclusion: Knowledge of the cortical and subcortical anatomical and functional borders of the resection is crucial in preoperative planning, prediction of the risk of postoperative deficits, and intraoperative decision making.

中文翻译：

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从神经外科的角度对顶叶进行皮质和皮质下解剖。

简介：顶叶在皮质和皮质下水平的解剖结构主要与感觉、视觉空间、视觉和语言功能有关。本研究的目的是在轴内病变的手术治疗方面提出这些关键结构的术中观点。该研究还讨论了该技术的结果和清醒条件下直接脑刺激的结果。材料和方法：根据 Klingler 技术制备五个成人大脑。用肉眼进行皮质评估和所有测量，而用显微镜放大进行白质解剖。结果：顶叶内的轴内病变可以通过横向或上方的轨迹接近。该决定基于与弓状束/上纵束 (AF/SLF) 复合体和心室系统相关的病变位置。无论采用何种入路，切除的功能边界均由前方的中央后回和下方的 Wernicke 言语区界定。在皮质下水平，应主动识别 AF/SLF 复合体和矢状层内的视辐射。在约 60% 的病例中，顶内沟 (IPS) 是 AF/SLF 复合体的可靠标志。结论：了解切除术的皮层和皮层下解剖和功能边界对于术前计划、术后功能缺损风险的预测和术中决策至关重要。