LIMBIC SYSTEM -„visceral brain“ - emotional reactions - sexual behaviour - care for offspring - social behaviour - memory - control of autonomic functions

Cortical parts inner zone: hippocampus, gyrus dentatus, subiculum, presubiculum, parasubiculum, indusium griseum outer zone: area enthorhinalis (28), lobus piriformis, gyrus cinguli neocortical paralimbic cortex: insula, anterior pole of temporal lobe, medial and orbital part of frontal lobe

Nuclei (tele-, di-, mesencephalon, pons) corpus amygdaloideum septum verum nucleus accumbens ncl. corporis mammillaris ncl. habenularis ncl. anteriores thalami ncl. interpeduncularis ncl. tegmentalis dorsalis Guddeni ncl. parabrachiales med.+lat.

Nuclei (aminergic nuclei) cholinergic nuclei: ncl. basalis Meynerti, ncl. tractus diagonalis Brocae + septalis med. v septum verum, ncl. preopticus magnocellularis v hypothalamu dopaminergic nuclei: pars compacta substantiae nigrae, nucleus subbrachialis formationis reticularis (= area tegmentalis ventralis Tsai) noradrenergic nuclei: locus coeruleus serotonergic nuclei: ncl. raphei med.+dors., ncl. centralis superior tegmenti Bechterevi (v RF) histaminergic nuclei: ncl. tuberomamillaris hypothalami

White matter of LS Fornix columnae (pars tecta – fibrae pre- + retrocommissurales, pars libera) corpus crura (+ commissura fornicis = Lyra Davidis) fimbria hippocampi (lying on hippocampus in cornu inferius ventriculi lateralis) taenia fornicis = attachment line of plexus choroideus ventriculi lateralis to fornix

White matter of LS Striae longitudinales corporis callosi medialis + lateralis Cingulum – association fascicle in gyrus cinguli Gyrus cinguli = area subcalosa, area cigularis ant.+post., area retrosplenialis, presubiculum Commissura anterior Tractus mammillothalamicus + mamillointerpeduncularis Fasciculus longitudinalis posterior

Olfaction cortex piriformis – anterior pole of temporal lobe cortical part of amygdala uncus gyri parahippocampalis anterior end of gyrus parahippocampalis main olfactory centre – orbitofrontal cortex

Main output axis of limbic system Septum verum  hypothalamus  RF of mesencephalon along fasciculus medialis telencephali = MFB

part of gyrus parahippocampalis facing cornu inferius centriculi lateralis (5cm long) Alveus = fibre layer on hippocampal surface, under ependyma –contains fibres running in fimbria hippocampi Regio I-IV (CA 1-CA 4) –Stratum moleculare (+ substratum lacunosum) –Stratum oriens –Stratum pyramidale –Stratu radiatum Gyrus dentatus –Stratum moleculare, granulare, multiforme Hippocampus proprius = cornu Ammonis

Hippocampal formation = hippocampus, subiculum, gyrus dentatus Gyrus dentatus –under fimbria hippocampi, medially to hippocampus –narrowing towards temporal lobe pole –termianes as oblique taenia Giacomini (separating uncus) –when reaching splenium corporis callosi  gyrus fasciolaris  indusim griseum+striae longitudinales corporis callosi

subiculum (archicortex) – superior part of gyrus parahippocampalis presubiculum (periarchicortex) periarchicortical band on medial surface of temporal lobe medially to subiculum parasubiculum (periarchicortex) Subicular complex

Hippocampus - connections afferents: olfaction, g. cinguli via cingulum, orbital cortex via fasc. uncinatus, amygdala  area entorhinalis (28)  H. hypothalamus, septum, contralateral hippocampus  fornix  H. efferents: from subiculum –  area entorhinalis (28) –fornix (precom.)  septum, hypothalamus (area preoptica), striatum ventrale, orbital and anterior cingulate cortex –fornix (precom.)  ncll. anteriores thalami –fornix (postcom.)  corpus mamillare

Hippocampus - lesion lesion of declarative memory (facts, events) –little retrograde amnesia –full antegrade amnesia (except short-time memory) amnesia of corpora mamillaria –chronic alcoholism –can cause Korsakov´s psychosis (amnestic confabulatory syndrom)

Hippocampal formation = hippocampus, subiculum, gyrus dentatus Gyrus dentatus –under fimbria hippocampi, medially to hippocampus –narrowing towards temporal lobe pole –termianes as oblique taenia Giacomini (separating uncus) –when reaching splenium corporis callosi  gyrus fasciolaris  indusim griseum+striae longitudinales corporis callosi

subiculum (archicortex) – superior part of gyrus parahippocampalis presubiculum (periarchicortex) periarchicortical band on medial surface of temporal lobe medially to subiculum parasubiculum (periarchicortex) Subicular complex

Corpus amygdaloidum (= amygdala = nucleus amgydalae) = archistriatum morphologic and developmental basal ganglion function and conections with limbic systém location: temporal lobe, in front of cornu inferius ventriculi lateralis and caudaa ncl. caudati complex of nuclei control of hypothalamus  „drive-related behaviour“ subjective feelings (fear, agression) bilateral lesion  no agressivity

Corpus amygdaloidum - division cortex periamygdalaris young – baso-lateral part – connection to cortex old – cortico-centromedial part – connection to olfaction; hypothalamus and brain stem

Petrovický, 2008

Corpus amygdaloidum - connections afferents: rich sensory and visceral efferents: –stria terminalis (along ncl. caudatus and v. thalamostriata)  septum + hypothalamus –ventral amygdalofugal pathway (under ncl. lentiformis)  septum + hypothalamus + piriform, orbital and antrerior cingulatecortex, ncl. accumbens, ncl. dorsomedialis thalami

Insula ??? area visceromotor innervation of GIT emotion of pain speech limbic function

Two main limbic subsystems Hippocampus (  gyrus cinguli + parahippocampalis  neocortex) ~ ncll. anteriores thalami + corpus mamillare Corpus amygdaloideum (  prefrontal (orbital) cortex and anterior temporal cortex  neocortex) ~ ncl. dorsomedialis thalami

Circuits of limbic system Limbic circuit of basal ganglia hippocampus, gyrus cinguli, orbitofrontal cortex, temporal cortex  ncl. accumbens  substantia nigra  pallidum ventrale  thalamus  orbitofrontal and anterior cingulate cortex beginning of motor respons visceromot respons via hypothalamus

Circuits of limbic system Papez´s limbic subcortical circuit (John Papez 1937) hippocampal formation  fornix  corpora mamillaria  fasciculus mamillothalamicus  ncll. anteriores thalami  area cingularis posterior  hippocampus + area entorhinalis recent, short version skips hypothalamus

BRAIN VENTRICLES and MENINGES

Meninges pachymeninx = dura mater dura mater cranialis dura mater spinalis leptomeninx –arachnoidea mater arachnoidea mater cranialis + spinalis – pia mater pia mater cranialis + spinalis

Dura mater dura mater cranialis –falx cerebri –tentorium cerebelli (+ incisura tentorii) –falx cerebelli –diaphragma sellae –cavum trigeminale dura mater spinalis (= saccus) – pars duralis fili terminalis

Dura mater – Arteries brain –a. meningea ant.  a. ethmoidalis ant.  a. ophtalmica  a. carotis int. – a. meningea media  a. maxillaris  a. carotis ext. – a. meningea post.  a. pharyngea asc.  a. carotis ext. –rr. meningei  a. occipitalis, a. vertebralis spinal cord –corresponds to spinal cord arteries

Dura mater – other supply Veins: brain – corresponds to arterires spinal cord – plexus venosi vertebrales interni Lymph: along veins to closest lypmh nodes !!! No lymphatic drainage in brain !!! Nerves: brain –r. tentorii  n. V 1 –r. meningeus  n. V 2, V 3, X, C 1 -C 3 (+ XII) spinal cord – rr. meningei  nn. spinales

Spaces around dura mater spatium epidurale –virtual space in brain –bleeding from aa. menigeae or disrupted venous sinuses –exsits around spinal cord (saccus d.m.) spatium subdurale –virtual space in both –bleeding from bridging veins

Arachnoidea mater spatium subarachnoideum – bleeding from Willis´s circle (often inborn aneurysmas) liquor cerebrospinalis (CSF) cisternae subarachniodeales Virchow-Robin´s spaces arachnoidea mater cranialis –granulationes arachnoideales Pacchioni (in foveolae granulares of calvaria) – resorption of CSF arachnoidea mater spinalis

Cisternae subarachnoideales c. cerebellomedullaris post. (= c. magna) c. cerebellomedullaris lat. c. fossae lateralis cerebri c. chiasmatis c. interpeduncularis c. ambiens c. pericallosa c. pontocerebellaris c. laminae terminalis c. quadrigeminalis (= c. venae cerebri magnae) c. lumbalis

Pia mater pia mater cranialis –tela choroidea ventriculi IV., III –plexus choroideus ventriculi IV.,III. –plexus choroideus ventriculi lateralis + glomus choroideum pia mater spinalis –lig. denticulatum –septum cervicale intermedium –pars pialis fili terminalis

Liquor cerebrospinalis (cerebrospinal fluid - CSF) pellucid, yellowish, alkalic plasma ions, little proteins and glucosis 2-5 lymphocytes per 1mm 3 total amount ml, ¼ in ventricles daily production: 500 ml puncture – lumbal L 3-4, suboccipital role of lymph in CNS

Brain ventricles ventriculi laterales ventriculus tertius ventriculus quartus – communication with spatium subarachnoideum ventriculus lumbalis (Krausei) false ventricles (no CSF !!!) ventriculus quintus Arantii, Wenzeli, Vieussensi = cavum septi pellucidi (10%) ventriculum sextus Vergae = cavum psalterii –between posterior 1/3 of truncus corporis callosi and commissura fornicis (psalterium), in case of their non-fusion

Ventriculus quartus floor: fossa rhomboidea Arantii ceiling (= tegmen) –vellum medullare sup. Willisi s.Vieussensi –fastigium –vellum medullare inf. –apertura mediana v.q. (= foramen Magendi) –obex (caudally) recessus lateralis – apertura lateralis v.q. (= foramen Luschkae) – paired aqueductus mesencephali Sylvii – communication to IIIrd ventricle

Ventriculus tertius foramen interventriculare Monroi apertura aqueductus mesencephali Vieussensi taenia thalami + stria medullaris thalami adhesio interthalamica (80%) recessus: –suprapinealis –pinealis –supraopticus –infundibuli –triangularis

Ventriculus lateralis paired cornu frontale/anterius pars centralis (atrium) cornu occipitale/posterius (bulbus) – calcar avis, eminentia collateralis Meckeli cornu temporale/inferius - hippocampus -stria terminalis -lamina affixa -taenia choroidea

Circumventricular organs missing HE barrier area postrema –by trigonum n. X - vomitting organum subfornicale organum subcommissurale organum vasculosum laminae terminalis –receptors for angiotensin II –secretion of hypothalamic products recessus pinealis, suprapinealis, infundibuli -derivates of ependym in ventricles -3 types of cells: ependymal, secretory, tanycytes

Brain arteries circulus arteriosus Willisi –a. cerebri anterior, media, posterior  cortical branches –a. communicans ant. (1) et post. (2)  cortical branches –a. choroidea ant.(  Willis), rr. posteriores (  a. cerebri post.) –aa. centrales  deep structures anteromediales anterolaterales (a. hemorrhagica Charcoti for putamen  stroke) !!! posteromediales posterolaterales –aa. vertebrales a. inferior posterior cerebelli –a. basilaris a. inferior anterior cerebelli  a. labyrinthi aa. pontis, aa. mesencephalicae a. superior cerebelli

Charcot´s artery/ies aa. centrales anterolaterales rr. laterales striati, „arterie lenticulostriatae“ branches from Willis, M1 or a. choroidea anterior supply to striatum, pallidum and capsula interna lesion: contralateral hemiplegia

Recurrent artery of Heubner branch from a. communicans anterior or A1/A2 segment of a. cerebri anterior caput ncl. caudati, crus anterius capsulae internae, anterior part of nucleus lentiformis, thalamus, hypothalamus and olfactory brain lesion: hemiplegia with faciobrachial predominance

Arteries of spinal cord 1.longituidnal: –a. spinalis ant. /unpaired, ventrally/  a.vertebralis –aa. spinales post. /4, dorsally/  a. inf. post. cerebelli  a. basilaris 2.transverse: branches of various arteries rr. spinales  aa. radiculares ant.+post.  aa. sulcomarginales + vasocoronae

Sources of rr. spinales a. vertebralis a. cervicalis ascendens a. cerviclais profunda aa. intercostales posteriores aa. lumbales a. iliolumbalis aa. sacrales laterales aa. radiculares irregular 5-9 a. radicularis magna Adamkiewiczi

Brain veins 1.vv. trunci encephali –v. pontomesencephalica (unpaired, in sulcus basilaris) vv. pontis + vv. medullae oblongatae –vv. cerebelli  v. cerebri magna, sinus rectus, transversus, sigmoideus, petrosus sup. 2.deep veins (= vv. profundae cerebri) –v. basalis Rosenthali (  vv. c. ant., v. c. media prof.)  v. c. magna –v. c. magna Galeni (unpired, short)  sinus rectus –v. c. interna v. thalamostriata sup. + v. choroidea ant (+ v. septi pellucidi ant.)

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Brain veins 3. vv. superficiales cerebri vv. superiores  sinus sagittalis sup. v. media superficialis  sinus cavernosus / sphenoparietalis v. anastomotica sup. Trolardi v. anastomotica inf. Labbéi vv. inferiores  sinus petrosi  sinus transversus