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Sulcal Patterns of the Medial Cerebral Cortex: A Comprehensive Scoping Review of Morphological and Morphometric Evidence

Gohil, P. R.; Sharma, P. N.; Vaishnani, H. V.

2025-09-18 neurology
10.1101/2025.09.17.25334987 medRxiv
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BackgroundThe medial cerebral cortex contains several sulci of high anatomical and clinical relevance, including the cingulate, paracingulate, calcarine, parieto-occipital, callosal, Rostral, supra-rostral and subparietal sulci. These structures serve as essential neuroanatomical landmarks and surgical corridors in microneurosurgical procedures, yet they exhibit considerable morphological variability. Although numerous studies have examined these sulci, no comprehensive synthesis exists focusing exclusively on cadaveric morphological and morphometric data, which remain critical for accurate neuroanatomical understanding. MethodsThis scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology and reported following the PRISMA-ScR checklist. A comprehensive literature search identified 4,440 records, of which 60 duplicates were removed. Screening of titles and abstracts excluded 3911 records, leaving 469 for full-text review. After applying eligibility criteria, eight cadaveric studies were included. Data were extracted on sample characteristics, morphological classification, and quantitative morphometry for the medial sulci. Findings were synthesized narratively and tabulated by sulcus type. ResultsThe included studies analyzed a total of 422 hemispheres from formalin-fixed cadaveric brains. The cingulate sulcus was consistently present in all examined specimens, whereas the paracingulate sulcus displayed marked variability. The calcarine sulcus demonstrated relatively stable morphometry, with mean anterior and posterior segment lengths ranging from 2.3 to 3.5 cm, yet exhibited variable bifurcation patterns and lunate sulcus connections. The parieto-occipital sulcus was a reliable boundary between the cuneus and precuneus, with mean lengths around 4.0 cm. The subparietal sulcus was described less frequently, highlighting a gap in detailed morphometric literature. ConclusionCadaveric evidence confirms both consistent and highly variable features in the medial cerebral sulci. These variations have direct implications for surgical planning, particularly in interhemispheric approaches. The paucity of detailed morphometric descriptions for certain sulci, especially the subparietal, callosal, rostral and supra-rostral sulcus, underscores the need for further targeted anatomical research.

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