CEREBRUM

Ariel Jose U Ampil, MD

Internist Diabetologist

Cerebrum
Composed of two hemispheres,
joined by masses of commissural
fibers
The longitudinal fissure incompletely
separates the two hemispheres
The falx cerbri lies within the
longitudinal fissure

Cerebrum
Gray matter = surface of the cerebral
cortex
White matter = beneath the gray matter
Basal ganglia = nuclear masses beneath
white matter
Gyrus = convoluted surface of the cortex
Sulcus = space separating the gyri
Fissure = deep sulcus

Classification of the Cerebral

Cortex
Neocortex
Mesocortex
Allocortex

Neocortex
Also known as the isocortex
Comprises 90% of the cortex
Composed of 6 layers:
1.
2.
3.
4.
5.
6.

Molecular (plexiform) layer

External granular layer
External pyramidal layer
Internal granular layer
Internal pyramidal layer
Multiform (polymorphic) layer

Mesocortex
Hippocampal gyrus
Cingulate gyrus

Allocortex
10% of the cortex
Composed of:
Paleocortex: olfactory cortex
Archicortex: hippocampus, dentate
gyrus

Lobes of the Cerebrum

Anatomic lobes
Frontal
Parietal
Occipital
Temporal

Synthetic lobes
Insular
Limbic

Frontal Lobe

Largest lobe
1/3 of hemisphers surface
Rostral to the central sulcus
Superior to the lateral fissure

Anatomic Parts of the

Frontal Lobe

Pre-central gyrus
Pre-central sulcus
Superior frontal gyrus
Superior frontal sulcus
Middle frontal gyrus
Inferior frontal sulcus
Inferior frontal gyrus

Functional Parts of the Frontal

Lobe

Primary motor cortex

Premotor cortex
Prefrontal cortex
Brocas speech area

Neurosyphilitic Frontal Lobe

Atrophy
Lack of a general sense of
responsibility
Sloppiness in habits
Vulgar speech
Clownish behavior

Pre-central Gyrus
Brodmann area 4
Primary motor area
1/3 of cortico-spinal tract arises from
here
Function: motor cortex (contralateral
movement of face, arm, leg and trunk)
Motor humunculus
Lesion:
Monoplegia or hemiplegia
Initially flaccid paralysis
Babinski reflex

Prefrontal gyrus

Brodmann area 6
Supplemental motor area
Rostral to pre-central gyrus
1/3 of cortico-spinal tract originates from
here
Function:
Contralateral turning of head and eyes
Assumption of posture
Complex patterned movements
Infrequent rapid incoordinate movements

Prefrontal gyrus
Lesion:
Paralysis of the head and eye movement
to the opposite side (head and eyes turn
toward the diseased hemisphere)
Spasticity
Increased tendon reflex added to
primary motor lesion

Frontal eyefield
Brodmann area 8
Located in the causal zone of the
middle frontal gyrus
Stimulation leads to conjugate
deviation of the eyes to the other side
Lesion results in difficulty in voluntary
movement of the eyes to the opposite
side

Prefontal cortex
Brodmann areas 9-12
Prefrontal area
Lies rostral to the premotor area and
frontal eyefield
Has connections with dorsomedial
nucleus of thalamus, hypothalamus,
limbic system, anterior temporal lobe
and association areas of parietal and
occipital lobes

Prefontal cortex
Function:

Personality
Abstract thinking
Mature judgement
Foresight
Tactfulness
Self-control
Initiative
Socialization of certain autonomic
functions and emotions
Monitor cortical plan of behavior

Prefontal cortex
Bilateral affectation results in:
Witzelsucht = inappropriate jocularity
Akinetic mutism = severe loss of
initiative with disinterest and unconcern
Primitive reflexes (e.g. grasp reflex)
Frontal ataxia = disurbance in gait
Paratonia = resistance of passive
movements of limbs

Paracentral lobule
Pre and post central gyri on the medial
surface
Anteriorly bounded by paracentral sulcus
Posterior border is the marginal branch of
the cingulate sulcus
Function:
Cortical inhibition of bladder and bowel voiding

Lesion:
Incontinence of urine and feces

Inferior Frontal Gyrus

Pars orbitalis
Pars triangularis
Pars opercularis

Brocas Area
Composed of pars triangularis and
pars opercularis
Brodmann areas 44 + 45
Expressive center for speech in the
dominant hemisphere
Patterns of movements for muscles
producing speech
Control motor speech

Brocas Area
Lesion in the dominant hemisphere
produces Brocas (motor or
expressive) dysphasia

Parietal Lobe
Posterior to the central sulcus
Rostral to the parieto-occipital gyrus
Composed of :
Postcentral gyrus (Brodmann areas 3, 1, 2)
Secondary somesthetic area
Superior parietal lobule
Inferior parietal lobule
Parietal operculum

Post-central Gyrus
Granular cortex / sensory cortex /
primar somesthetic area
Brodmann areas 3, 1, 2
Cortical regions where impulses
concerned with tactile and kinesthetic
sense from superficial and deep
receptors converge and are
somatopically represented (sensory
humunculus)

Post-central Gyrus
Functions to receive afferent pathways for
appreciation of posture, touch and passive
movements
Lesions result in:
contralateral impairment of touch, pressure and
proprioception
Disturbed postural and passive sensation
Disturbed localization of touch with loss of twopoint discrimination
Astereognosis = impaired appreciation of size,
shape, texture and weight
Perceptual rivalry = sensory inattention

Secondary Somesthetic
Area
Posterior to BA 3, 1, 2
Lies along superior border of the
Sylvian fissure
Lesions result in impaired pain
sensation

Superior Parietal Lobule

Separated from the inferior parietal
lobule by the intraparietal sulcus
Brodmann areas 5 + 7

Inferior Parietal Lobule

Composed of two gyri:
Supramarginal gyrus
Angular gyrus

Cortical association areas

Mnemonic constallations for
understanding and interpreting
sensory signals

Supramarginal Gyrus
Brodmann area 40
Functions in understanding and
interpretting sensory signals
Lesions in dominant hemisphere result
in tactile and proprioceptive agnosia
Lesions in non-dominant hemispheres
result in confusion left-right
discrimination, body image disturbance
and apraxia

Angular Gyrus
Surround ascending terminal part of
superior temporal sulcus
Brodmann area 39
Association cortex which has
connections with somesthetic, visual
and auditory association areas
Lesions in dominant hemisphere
result in alexia (inability to read) and
agraphia (inability to write)

Visual Pathway of the

Parietal Lobe
Optic radiation
Where fibers of the optic radiation
(lower visual field) pass through the
parietal lobe
Results in lower homonymous
quadrantanopsia

Parietal Operculum
Located in the roof of the lateral
fissure
Brodmann are 43
functions for taste sensibility

Sensory or Ideational Speech

Area
Supramarginal gyrus
Angular gyrus

Nondominant parietal lobe

Important for visual and
proprioceptive skills to construct
shapes
Functions in body image and
awareness of external environment

Nondominant Parietal Lobe

Visual and proprioceptive skills to
construct shapes
Functions in:
body image and awareness of external
environment
Visual and proprioceptive skills
Spatial orientation

Nondominant Parietal Lobe

Lesions result in:
Asomatognosia
Anosognosia (denial of weakness)
Dressing apraxia
Geographical apraxia
Contructional apraxia unawae of
opposite limb (left side)

Dominant Parietal Lobe

Important for appreciation of
numbers and calculation
Lesion results in:
Gertsmanns syndrome
Confusion of right and left limbs
Finger agnosia (difficulty in distinguishing
finger from hand)
Acaclculia
Agraphia

Temporal Lobe
Superior temporal gyrus
Primary auditory cortex
Secondary auditory cortex

Superior temporal sulcus

Middle temporal gyrus
Inferior temporal sulcus
Inferior temporal gyrus

Superior Temporal Gyrus

Parallel with the lateral fissure
Lesions present with auditory
hallucinations (by diseases like
complex partial siezures) and vertigo

Primary Auditory Cortex

Located on the transverse gyri of Heschl
(several short oblique convolutions on
the inner bank of the lateral sulcus)
Upper surface of superior temporal
gyrus
Brodmann areas 41, 42
Functions:
Dominant hemisphere = hearing language
Nondominant hemisphere = hearing sound,
rhythm and music; labyrinthine function

Primary Auditory Cortex

Lesions results in:
Cortical deafness
Dominant hemisphere = difficulty hearing
spoken words
Nondominant hemisphere = difficulty
appreciating sound, rhythm and music
(amusia)
Unilateral lesions have little effects on
hearing (significant auditory defects involve
either CN 8 or its entry in the brainstem)

Secondary Auditory Cortex

Auditory associational area
Brodmann area 22
Function: dominant hemisphere =
language comprehension
Lesion: Wernickes aphasia (receptive
/ sensory aphasia)

Middle and Temporal Gyrus

Involved in memory and learning
Lesions result in disturbance in
memory and learning

Visual Pathway of the Temporal

Lobe
Optic radiation
Where fibers of the optic radiation
(upper visual field) pass through the
temporal lobe
Results in upper homonymous
quadrantanopsia

Primary Olfactory Area

Composed of prepyriformis and
periamygdaloid area
For the sense of smell

Occipital Lobe
Above tentorium cerebelli
Separated from parietal lobe the
parieto-occipital sulcus
Consists of:
Lateral occipital gyri
Cuneus
Calcarine sulcus
Lingual gyrus

Occipital Lobe
Involved in visual perception
Cortical lesion = homonymous
hemianopsia
Occipital pole only = central
hemianopsia involving the macula
Extensive damage of the striate cortex
results in Antons syndrome
Denial of cortical blindness
Intact pupillary light reflex

Primary Visual Cortex

Located along the banks of the calcarine
sulcus
Calcarine sulcus joins parieto-occipital
sulcus rostrally in a Y shaped formation

Brodmann area 17
Perception of contralateral half of the
visual field
Recieves impulses from temporal half of
ipsilateral retina and nasal half of
contralateral retina
Lesion results in cortical blindness in the
contralateral visual field

Secondary Visual Area

Lies adjacent and anterior to BA 17
Brodmann area 18, 19
Involved in visual perception and
visual reflexes (i.e. visual fixation)
Lesions results in visual agnosia
(difficulty in recognizing and
identifying objects visually)

Inferior Surface of Cerebrum

Olfactory sulcus separates lateral orbital gyri from
medial gyrus rectus
Olfactory bulb and tract inferior to the olfactory
sulcus
Inferior surface lies in the middle fossa of the skull,
reveals part of the inferior temporal gyrus, the broad
occipito-temporal gyrus and the parahippocampal
gyrus
Uncus
Most medial protrusion of the parahippocampal gyrus
Separated from the occipito-temporal gyrus by the
collateral sulcus

Primary olfactory cortex

Rostral part of parahippocampal gyrus
Uncus
Lateral olfactory stria

Insula
Island of Reil
Buried in the depths of the lateral sulcus
Can only be seen when temporal and frontal
lobes are separated
A triangular cortical area with the apex directed
fprward and downward to open to the latreral
fossa
Covered by gyri breves and longus, nearly
parallel to lateral sulcus
Limen insula opening leading to the insular
region
Temporal, frontal and parietal opercular regions
cover the insula

Limbic System
Visceral brain
Includes a diverse group of medial
and basal telencephalic structures,
which represent those regions of the
cerebral cortex having the most direct
connections with the hypothalamus
Defensive reactions such as fear or
rage are integrated diffusely

Limbic System
Other structures closely related to
the limbic system
Posterior orbito-frontal cortex
Anterior temporal cortex
Anterior nuclear group of the thalamus
Hypothalamus
Septal region
Midline nuclei

afferent

structure

efferent

function

Cingulate gyrus
Neocortex
Septum

Hippocampal
formation

Fornix
Precommisural
fibers
Postcommosura
l fibers

Memory and
learning;
Integrating
sensory input

Olfactory bulb
Rostral
hypothalamus
Inferior
temporal lobe
Orbitofrontal
cortex
Brainstem
reticular
formation

amygdala

Stria terminalis
Ventral
amygdalofugal
projection

Stimulation
leads to rage
reaction
Lesions results
in docility

Cingulate gyrus

Parahippocamp
al gyrus

Hippocampus

Anterior nuclear Cingulate gyrus

nuclear group
of the thalamus
Association

Cingulum
entorhinal area
of the
parahippocamp

Papez Circuit
Parts of limbic system and
diencephalon
Concerned with emotion
Hippocampal formation (fornix)
mammillary body
(mammillothalamic tract) anterior
nuclear group of the thalamus
cingulate gyrus

Kluver Bucy Syndrome

Bilateral lesions destroying the amygdala
and hipppocampus in male monkeys
Manifestations

Psychic blindness
Hypermetamorphosis
Hyperorality
Hypersexuality and loss of sexual preference
Reversal of individual behavioral patterns
Marked absence of emotional response
Loss of facial expression and vocal protests

Other clinical manifestations

Bilateral damage to the medial
temporal lobes results in anterograde
amnesia, which is a profound loss of
the ability to acquire new information
Korsakoffs psychosis also present
with anterograde amnesia, affected
by lesions in the mammillary bodies
and the dorsomedial nucleus of the
thalamus

Thank you very

much
for your kind
attention!