Correlation between anatomy and computed tomography in the occipito-temporal plane: application to cerebral lobectomy

Identification of the anatomic limits of cerebral lobectomies has for long been based on the indirect data provided by ventriculography, arteriography and the statistical anatomic details of the stereotactic atlases. Today, it is simple to identify the cerebral anatomic structures directly on scanner sections, to assess the limits of a required lobectomy and to monitor the outcome. This appears to be just as valid in clinical conditions where the anatomic structures remain near-normal (surgery of epilepsy) as in those where they may be deformed (such as the surgery of malignant gliomata). In order to establish precise correlations between the anatomy and the computed tomographic findings, a study in the occipito-temporal plane used regularly in CT was carried out in 18 brains. Frontal, temporal and occipital lobectomies were performed on these brains using the anatomic landmarks commonly accepted in neurosurgery. The practical import of these theoretic lobectomies studied in the OT plane is illustrated by some examples of surgical excision of lobar cerebral lesions.