OBJECTIVE
To present and describe the features of the anatomy of the anterior commissure of the brain in relation to the surgery of drug-resistant forms of epilepsy.
MATERIAL AND METHODS
8 cerebral hemispheres (2 men and 2 women; mean age 56 years, no history of neurological disease) were examined after autopsy. All brain preparations were prepared according to the J.Klingler method. Microsurgical dissection of the anterior commissure was performed using an operating microscope under magnification from 6 to 40 with step-by-step photo and video recording.
RESULTS
The anterior commissure is a bundle of white matter, almost completely surrounded by gray matter. Its shape can be compared to a «bicycle handlebar» crossing the midline ventrally towards the supraoptic cavity of the third ventricle and towards the pillars of the fornix. At a distance of about 1.5 cm from the central line from the anterior commissure, ventral fibers extend towards the poles of the frontal lobes. Further, the anterior commissure is covered with a thin and dense membrane up to the amygdala, called the Graziole canal. After the ventral fibers leave, the trunk of the anterior commissure continues laterally, parallel to the optic tract, gradually branching into fibers that reach the cortex of the temporal lobes in its anterior, middle and posterior sections.
CONCLUSION
The anatomical features of the anterior commissure of the brain are clearly presented and described in relation to the surgery of drug-resistant forms of epilepsy. With the help of the dissection of white matter fibers according to the Klinger method, the interconnection of the temporal lobe cortex with each other, through the fibers passing through the anterior commissure, was anatomically confirmed. The technique of anterior commissurotomy is described in detail as a method of disconnecting this connection to prevent generalization of seizures in temporal lobe forms of drug-resistant epilepsy. The ventral fibers of the anterior commissure are visualized, to both frontal lobes of the brain. These anatomical data can be applied to the development of new methods of surgical treatment of frontal forms of drug-resistant epilepsy.
