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The insular cortex: morphological and vascular anatomic characteristics

G G Varnavas1, W Grand

  • 1Department of Neurosurgery, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, New York, USA.

Neurosurgery
|January 23, 1999
PubMed
Summary
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This study reveals the insula

Area of Science:

  • Neuroanatomy
  • Vascular Anatomy
  • Surgical Anatomy

Background:

  • The insula's complex vascularization is crucial for surgical planning.
  • Existing literature suggests primary drainage via the deep middle cerebral vein (DMCV).

Purpose of the Study:

  • To anatomically investigate the insula's vasculature.
  • To describe its morphological features and cortical relationships.
  • To provide data for safe surgical and endovascular interventions.

Main Methods:

  • Dissection of 53 adult cadaver hemispheres under magnification (x2-x32).
  • Identification of opercular landmarks to guide deeper insular dissection.

Main Results:

  • The insula exhibits complex venous drainage, typically combining superficial and deep connections (94.3%).

Related Experiment Videos

  • Venous drainage divides the insular cortex into subapical, anterior, and posterior zones.
  • Arterial supply originates from the middle cerebral artery, predominantly via the superior division, often with a single dedicated terminal vessel (67.9%).

    • Conclusions:

    • Insular venous drainage is more complex than previously reported, involving both superficial and deep systems.
    • The deep middle cerebral vein (DMCV) primarily drains lateral lenticular veins, with secondary drainage of the insula.
    • Arterial supply is centered around the central insular sulcus, offering insights for neurosurgical procedures.