1. LIMBIC SYSTEM • „visceral brain“ • emotional reactions • sexual behaviour • care for offspring • social behaviour • memory • control of autonomic functions

2. Cortical parts • inner zone: hippocampus, gyrus dentatus, subiculum, presubiculum, parasubiculum, indusium griseum • outer zone: area enthorhinalis (28), lobus piriformis, gyrus cinguli • neocortical paralimbic cortex: insula, anterior pole of temporal lobe, medial and orbital part of frontal lobe

5. Nuclei (tele-, di-, mesencephalon, pons) • corpus amygdaloideum • septum verum • nucleus accumbens • ncl. corporis mammillaris • ncl. habenularis • ncl. anteriores thalami • ncl. interpeduncularis • ncl. tegmentalis dorsalis Guddeni • ncl. parabrachiales med.+lat.

6. Nuclei (aminergic nuclei) • cholinergic nuclei:ncl. basalis Meynerti, ncl. tractus diagonalis Brocae + septalis med. v septum verum, ncl. preopticus magnocellularis v hypothalamu • dopaminergic nuclei: pars compacta substantiae nigrae, nucleus subbrachialis formationis reticularis (= area tegmentalis ventralis Tsai) • noradrenergic nuclei: locus coeruleus • serotonergic nuclei: ncl. raphei med.+dors., ncl. centralis superior tegmenti Bechterevi (v RF) • histaminergic nuclei: ncl. tuberomamillaris hypothalami

7. White matter of LS Fornix • columnae (pars tecta – fibrae pre- + retrocommissurales, pars libera) • corpus • crura (+ commissura fornicis = Lyra Davidis) • fimbria hippocampi (lying on hippocampus in cornu inferius ventriculi lateralis) • taenia fornicis = attachment line of plexus choroideus ventriculi lateralis to fornix

8. White matter of LS • Striae longitudinales corporis callosi medialis + lateralis • Cingulum – association fascicle in gyrus cinguliGyrus cinguli = area subcalosa, area cigularis ant.+post., area retrosplenialis, presubiculum • Commissura anterior • Tractus mammillothalamicus + mamillointerpeduncularis • Fasciculus longitudinalis posterior

9. Olfaction cortex piriformis – anterior pole of temporal lobe • cortical part of amygdala • uncus gyri parahippocampalis • anterior end of gyrus parahippocampalis • main olfactory centre – orbitofrontal cortex

10. Main output axis of limbic system Septum verum  hypothalamus  RF of mesencephalon • along fasciculus medialis telencephali = MFB

12. Hippocampus proprius = cornu Ammonis • part of gyrus parahippocampalis facing cornu inferius centriculi lateralis (5cm long) • Alveus = fibre layer on hippocampal surface, under ependyma • contains fibres running in fimbria hippocampi • Regio I-IV (CA 1-CA 4) • Stratum moleculare (+ substratum lacunosum) • Stratum oriens • Stratum pyramidale • Stratu radiatum • Gyrus dentatus • Stratum moleculare, granulare, multiforme

13. Hippocampal formation = hippocampus, subiculum, gyrus dentatus • Gyrus dentatus • under fimbria hippocampi, medially to hippocampus • narrowing towards temporal lobe pole • termianes as oblique taenia Giacomini(separating uncus) • when reaching splenium corporis callosi  gyrus fasciolaris  indusim griseum+striae longitudinales corporis callosi

14. Subicular complex • subiculum (archicortex) – superior part of gyrus parahippocampalis • presubiculum (periarchicortex) • periarchicortical band on medial surface of temporal lobe • medially to subiculum • parasubiculum (periarchicortex)

15. Hippocampus - connections • afferents: olfaction, g. cinguli via cingulum, orbital cortex via fasc. uncinatus, amygdala  area entorhinalis (28)  H. hypothalamus, septum, contralateral hippocampus  fornix  H. • efferents: from subiculum •  area entorhinalis (28) • fornix (precom.) septum, hypothalamus (area preoptica), striatum ventrale, orbital and anterior cingulate cortex • fornix (precom.)  ncll. anteriores thalami • fornix (postcom.)  corpus mamillare

16. Hippocampus - lesion • lesion of declarative memory (facts, events) • little retrograde amnesia • full antegrade amnesia (except short-time memory) • amnesia of corpora mamillaria • chronic alcoholism • can cause Korsakov´s psychosis (amnestic confabulatory syndrom)

17. Hippocampal formation = hippocampus, subiculum, gyrus dentatus • Gyrus dentatus • under fimbria hippocampi, medially to hippocampus • narrowing towards temporal lobe pole • termianes as oblique taenia Giacomini(separating uncus) • when reaching splenium corporis callosi  gyrus fasciolaris  indusim griseum+striae longitudinales corporis callosi

18. Subicular complex • subiculum (archicortex) – superior part of gyrus parahippocampalis • presubiculum (periarchicortex) • periarchicortical band on medial surface of temporal lobe • medially to subiculum • parasubiculum (periarchicortex)

19. Corpus amygdaloidum (= amygdala = nucleus amgydalae) = archistriatum • morphologic and developmental basal ganglion • function and conections with limbic systém • location: temporal lobe, in front of cornu inferius ventriculi lateralis and caudaa ncl. caudati • complex of nuclei • control of hypothalamus  „drive-related behaviour“ • subjective feelings (fear, agression) • bilateral lesion no agressivity

20. Corpus amygdaloidum - division • cortex periamygdalaris • young – baso-lateral part – connection to cortex • old – cortico-centromedial part – connection to olfaction; hypothalamus and brain stem

21. Petrovický, 2008

22. Corpus amygdaloidum - connections • afferents: rich sensory and visceral • efferents: • stria terminalis (along ncl. caudatus and v. thalamostriata)  septum + hypothalamus • ventral amygdalofugal pathway (under ncl. lentiformis)  septum + hypothalamus + piriform, orbital and antrerior cingulatecortex, ncl. accumbens, ncl. dorsomedialis thalami

23. Insula ??? • area 13-16 • visceromotor innervation of GIT • emotion of pain • speech • limbic function

24. Two main limbic subsystems • Hippocampus ( gyrus cinguli + parahippocampalis  neocortex) ~ ncll. anteriores thalami + corpus mamillare • Corpus amygdaloideum ( prefrontal (orbital) cortex and anterior temporal cortex  neocortex) ~ ncl. dorsomedialis thalami

25. Circuits of limbic system • Limbic circuit of basal ganglia hippocampus, gyrus cinguli, orbitofrontal cortex, temporal cortex  ncl. accumbens  substantia nigra  pallidum ventrale  thalamus  orbitofrontal and anterior cingulate cortex beginning of motor respons visceromot respons via hypothalamus

26. Circuits of limbic system • Papez´s limbic subcortical circuit (John Papez 1937)hippocampal formation  fornix  corpora mamillaria  fasciculus mamillothalamicus  ncll. anteriores thalami  area cingularis posterior  hippocampus + area entorhinalis • recent, short version skips hypothalamus

27. BRAIN VENTRICLESandMENINGES

28. Meninges • pachymeninx = dura mater • dura mater cranialis • dura mater spinalis • leptomeninx • arachnoidea mater • arachnoidea mater cranialis + spinalis • pia mater • pia mater cranialis + spinalis

29. Dura mater • dura mater cranialis • falx cerebri • tentorium cerebelli (+ incisura tentorii) • falx cerebelli • diaphragma sellae • cavum trigeminale • dura mater spinalis (= saccus) • pars duralis fili terminalis

30. Dura mater – Arteries • brain • a. meningea ant.  a. ethmoidalis ant.  a. ophtalmica  a. carotis int. • a. meningea media  a. maxillaris  a. carotis ext. • a. meningea post.  a. pharyngea asc.  a. carotis ext. • rr. meningei  a. occipitalis, a. vertebralis • spinal cord • corresponds to spinal cord arteries

31. Dura mater – other supply • Veins: brain – corresponds to arterires spinal cord – plexus venosi vertebrales interni • Lymph: along veins to closest lypmh nodes !!! No lymphatic drainage in brain !!! • Nerves: brain • r. tentorii  n. V1 • r. meningeus  n. V2, V3, X, C1-C3(+ XII) spinal cord – rr. meningei  nn. spinales

32. Spaces around dura mater • spatium epidurale • virtual space in brain • bleeding from aa. menigeae or disrupted venous sinuses • exsits around spinal cord (saccus d.m.) • spatium subdurale • virtual space in both • bleeding from bridging veins

33. Arachnoidea mater • spatium subarachnoideum – bleeding from Willis´s circle (often inborn aneurysmas) • liquor cerebrospinalis (CSF) • cisternae subarachniodeales • Virchow-Robin´s spaces • arachnoidea mater cranialis • granulationes arachnoideales Pacchioni (in foveolae granulares of calvaria) – resorption of CSF • arachnoidea mater spinalis

34. Cisternae subarachnoideales • c. cerebellomedullaris post. (= c. magna) • c. cerebellomedullaris lat. • c. fossae lateralis cerebri • c. chiasmatis • c. interpeduncularis • c. ambiens • c. pericallosa • c. pontocerebellaris • c. laminae terminalis • c. quadrigeminalis (= c. venae cerebri magnae) • c. lumbalis

36. Pia mater • pia mater cranialis • tela choroidea ventriculi IV., III • plexus choroideus ventriculi IV.,III. • plexus choroideus ventriculi lateralis + glomus choroideum • pia mater spinalis • lig. denticulatum • septum cervicale intermedium • pars pialis fili terminalis

37. Liquor cerebrospinalis(cerebrospinal fluid - CSF) • pellucid, yellowish, alkalic • plasma ions, little proteins and glucosis • 2-5 lymphocytes per 1mm3 • total amount 100-180 ml, ¼ in ventricles • daily production: 500 ml • puncture – lumbal L3-4, suboccipital • role of lymph in CNS

38. Brain ventricles • ventriculi laterales • ventriculus tertius • ventriculus quartus – communication with spatium subarachnoideum • ventriculus lumbalis (Krausei) false ventricles (no CSF !!!) • ventriculus quintus Arantii, Wenzeli, Vieussensi = cavum septi pellucidi (10%) • ventriculum sextus Vergae = cavum psalterii • between posterior 1/3 of truncus corporis callosi and commissura fornicis (psalterium), in case of their non-fusion

39. Ventriculus quartus • floor: fossa rhomboidea Arantii • ceiling (= tegmen) • vellum medullare sup. Willisi s.Vieussensi • fastigium • vellum medullare inf. • apertura mediana v.q. (= foramen Magendi) • obex (caudally) • recessus lateralis – apertura lateralis v.q. (= foramen Luschkae) – paired • aqueductus mesencephali Sylvii – communication to IIIrd ventricle

41. Ventriculus tertius • foramen interventriculare Monroi • apertura aqueductus mesencephali Vieussensi • taenia thalami + stria medullaris thalami • adhesio interthalamica (80%) • recessus: • suprapinealis • pinealis • supraopticus • infundibuli • triangularis

42. Ventriculus lateralis • paired • cornu frontale/anterius • pars centralis (atrium) • cornu occipitale/posterius (bulbus) – calcar avis, eminentia collateralis Meckeli • cornu temporale/inferius - hippocampus • stria terminalis • lamina affixa • taenia choroidea

43. Circumventricular organs missing HE barrier • area postrema • by trigonum n. X - vomitting • organum subfornicale • organum subcommissurale • organum vasculosum laminae terminalis • receptors for angiotensin II • secretion of hypothalamic products • recessus pinealis, suprapinealis, infundibuli • derivates of ependym in ventricles • 3 types of cells: ependymal, secretory, tanycytes

44. Brain arteries • circulus arteriosus Willisi • a. cerebri anterior, media, posterior  cortical branches • a. communicans ant. (1) et post. (2)  cortical branches • a. choroidea ant.(Willis), rr. posteriores (a. cerebri post.) • aa. centrales  deep structures • anteromediales • anterolaterales (a. hemorrhagica Charcoti for putamen  stroke) !!! • posteromediales • posterolaterales • aa. vertebrales • a. inferior posterior cerebelli • a. basilaris • a. inferior anterior cerebelli  a. labyrinthi • aa. pontis, aa. mesencephalicae • a. superior cerebelli

45. Charcot´s artery/ies • aa. centrales anterolaterales • rr. laterales striati, „arterie lenticulostriatae“ • branches from Willis, M1 or a. choroidea anterior • supply to striatum, pallidum and capsula interna • lesion: contralateral hemiplegia

46. Recurrent artery of Heubner • branch from a. communicans anterior or A1/A2 segment of a. cerebri anterior • caput ncl. caudati, crus anterius capsulae internae, anterior part of nucleus lentiformis, thalamus, hypothalamus and olfactory brain • lesion: hemiplegia with faciobrachial predominance

50. Arteries of spinal cord • longituidnal: • a. spinalis ant. /unpaired, ventrally/  a.vertebralis • aa. spinales post. /4, dorsally/  a. inf. post. cerebelli  a. basilaris • transverse: branches of various arteries rr. spinales  aa. radiculares ant.+post. • aa. sulcomarginales + vasocoronae