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Anatomic Dissections of the Intrasylvian Membranes

Surgical Correlation

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Anatomic Dissections of the Intrasylvian Membranes. A, Superior view of the left temporal lobe. The yellow interrupted line shows the site of the outer arachnoid, and the light and dark green interrupted lines show the site of attachment of the lateral and intermediate sylvian membranes. The lateral sylvian membrane spans the lateral part of the sylvian fissure and extends from the frontoparietal to the temporal operculum deep to the superficial sylvian veins. The intermediate sylvian membrane attaches along the medial side of the superior temporal gyrus anteriorly and along the medial edge of Heschl’s gyrus posteriorly. The upper surface of the temporal lobe medial to the intermediate sylvian membrane is the site of a shallow trough along which the M2 trunks pass. The part medial to the intermediate sylvian membrane narrows posteriorly, where the membrane extends posteromedially along the C medial edge of the transverse temporal gyri, which form the full width of the temporal operculum in the posterior part of the fissure. B, Superior view of the right temporal lobe with the superficial sylvian vein and middle cerebral arteries preserved. The superficial sylvian veins course between the outer arachnoid and lateral sylvian membranes. The M2 trunks course on the medial side of the intermediate sylvian membrane. The M3 trunks penetrate the intermediate and lateral sylvian membranes to reach the cortical surface. C, Inferior view of the right frontoparietal operculum. The medial sylvian membrane (blue interrupted line) attaches along the deep edge of the frontoparietal operculum. The lower attachment of the medial sylvian membrane is to the midlevel of the insula on the medial side of the M2 trunks. The intermediate sylvian membrane attaches along the medial part of the frontoparietal operculum. The lateral sylvian membrane attaches to the lateral edge of the frontoparietal operculum deep to the superficial sylvian veins. D, Inferior view of the right frontoparietal operculum with the arteries preserved. The medial sylvian membrane attaches along the deep edge of the frontoparietal operculum, extends downward on the medial side of the M2 trunks, and attaches to the insular surface. The intermediate sylvian membrane spans the interval lateral to the M2 trunks, and the lateral sylvian membrane is positioned deep to the superficial sylvian veins. The M3 trunks penetrate the intermediate and lateral sylvian membranes to reach the cortical surface. (Images courtesy of AL Rhoton, Jr.)

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