Brain sulci and gyri: a practical anatomical review

Despite technological advances, such as intraoperative MRI, intraoperative sensory and motor monitoring, and awake brain surgery, brain anatomy and its relationship with cranial landmarks still remains the basis of neurosurgery. Our objective is to describe the utility of anatomical knowledge of brain sulci and gyri in neurosurgery. This study was performed on 10 human adult cadaveric heads fixed in formalin and injected with colored silicone rubber. Additionally, using procedures done by the authors between June 2006 and June 2011, we describe anatomical knowledge of brain sulci and gyri used to manage brain lesions. Knowledge of the brain sulci and gyri can be used (a) to localize the craniotomy procedure, (b) to recognize eloquent areas of the brain, and (c) to identify any given sulcus for access to deep areas of the brain. Despite technological advances, anatomical knowledge of brain sulci and gyri remains essential to perform brain surgery safely and effectively.