1.Favored gyral sites of supratentorial astrocytic tumors
Naci Balak ; Recai Türkoğlu ; Ramazan Sarı ; Belma Aslan ; Ebru Zemheri ; Nejat Işık
Neurology Asia 2011;16(1):71-79
It is well known that the predilective sites of extrinsic tumors (meningiomas, chordomas, etc) are
at the skull base and along the calvarium. Although intrinsic tumors or glial tumors have also been
seen to have anatomic and functional predilective sites within the central nervous system, these have
not been well documented. We conducted this study to investigate if supratentorial astrocytic tumors
have a predilection for specifi c gyri. We investigated the clinical and radiological records of 60
successive patients who had been operated on at our institution and had had histologically confi rmed
supratentorial astrocytic tumors (36 males, 24 females, mean age: 52 years). Coronal sections were
selected from the pre-operative contrast enhanced T1-weighted magnetic resonance imaging (MRI). The
labeling of gyral areas for analysis of MRI was done using Yaşargil’s method. Additional information
obtained from 3-dimensional MRI and surgical fi ndings was taken into account when it was diffi cult
to distinguish the specifi c gyrus in which the tumor was located. The middle portions of the frontal
gyri, insular gyri and the supramarginal gyrus and its surroundings were among the most common
locations for the development of tumors. Interestingly, with the exception of one case, none of the
tumors was situated in the precentral or postcentral gyri. It seems that supratentorial astrocytic tumors
have a predilection for specifi c gyri and disfavor some other gyri. This cannot be explained simply
by the different sizes of the cerebral lobes. A classical lobar concept of cerebral anatomy may lead
to a misunderstanding of cerebral pathophysiology.