Central sulcus
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The central sulcus (of Rolando) is a very important landmark in both anatomical and functional neuroanatomy.
Gross anatomy
The central sulcus separates the frontal lobe from the parietal lobe, and also separates the primary motor cortex anteriorly from the primary somatosensory cortex posteriorly 1.
Radiographic features
LandmarksA number of landmarks and signs that arehave been identified as being variably useful in identifying the central sulcus on cross-sectional imaging.
The central sulcus tends to be the longest sulcus in a roughly coronal plane, and reaching the midline to enter the interhemispheric fissure. This is sometimes referred to as the midline sulcus sign. Although this is probably the best-known feature, unfortunately in practice is not terribly reliable and thus numerous other features/signs have been described to aid identification of various regional anatomic features. These include 1,3:
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upper T sign or L sign: identifying the superior frontal sulcus which intersects the precentral sulcus in a "T"
oror "L" junction, thus defining the precentral gyrus. The central sulcus is the next posterior sulcus. - lower T sign or M sign: identifying the inferior frontal sulcus, or inferior frontal gyrus (which has a characteristic "M" configuration), which terminates posteriorly in the precentral sulcus and gyrus respectively. The central sulcus is the next posterior sulcus.
- bracket sign: the marginal sulcus is visible immediately posterior to the central sulcus, and is easily identifiable of sagittal paramedian images as the continuation of the cingulate sulcus
- thin postcentral gyrus sign: the postcentral gyrus is thinner than the precentral gyrus
- sigmoidal hook sign or omega sign: location of hand knob identifying the precentral gyrus
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intraparietalbifid postcentral sulcus sign:postcentralat the medial most extent the postcentral gyrus is split by the marginal sulcus - U sign: the most inferolateral extent of the central sulcus is capped by a "U" shaped gyrus – the subcentral gyrus – which abuts the lateral fissure
Although various individuals and publications expound the virtues of one or more of these signs, the reality is that in practice one should use as many of them as possible to understand the local anatomy. In the vast majority of cases, unless there are serious congenital sulcation anomalies, prior damage (e.g. surgery) or distorting masses (e.g. tumours), the central sulcus can be identified with certainty by evaluating the region for the above features. In cases where anatomy is uncertain, or it is of critical importance to confirm the anatomy, then functional MRI can be performed, particularly aimed at identifying the hand motor cortex.
-<p>The <strong>central sulcus</strong> (<strong>of Rolando</strong>) is a very important landmark in both anatomical and functional neuroanatomy.</p><h4>Gross anatomy</h4><p>The central sulcus separates the <a href="/articles/frontal-lobe">frontal lobe</a> from the <a href="/articles/parietal-lobe">parietal lobe</a>, and also separates the <a href="/articles/primary-motor-cortex">primary motor cortex</a> anteriorly from the<a href="/articles/primary-somatosensory-cortex"> primary somatosensory cortex</a> posteriorly <sup>1</sup>.</p><h4>Radiographic features</h4><p>Landmarks and signs that are useful in identifying the central sulcus on cross-sectional imaging include <sup>1</sup>:</p><ul>-<li>identifying the <a href="/articles/superior-frontal-sulcus">superior frontal sulcus</a> which intersects the <a href="/articles/precentral-sulcus">precentral sulcus</a> in a "T" or "L" junction, thus defining the <a href="/articles/precentral-gyrus">precentral gyrus</a>. The central sulcus is the next posterior sulcus.</li>- +<p>The <strong>central sulcus</strong> (<strong>of Rolando</strong>) is a very important landmark in both anatomical and functional neuroanatomy.</p><h4>Gross anatomy</h4><p>The central sulcus separates the <a href="/articles/frontal-lobe">frontal lobe</a> from the <a href="/articles/parietal-lobe">parietal lobe</a>, and also separates the <a href="/articles/primary-motor-cortex">primary motor cortex</a> anteriorly from the<a href="/articles/primary-somatosensory-cortex"> primary somatosensory cortex</a> posteriorly <sup>1</sup>.</p><h4>Radiographic features</h4><p>A number of landmarks and signs have been identified as being variably useful in identifying the central sulcus on cross-sectional imaging. </p><p>The central sulcus tends to be the longest sulcus in a roughly coronal plane, and reaching the midline to enter the interhemispheric fissure. This is sometimes referred to as the midline sulcus sign. Although this is probably the best-known feature, unfortunately in practice is not terribly reliable and thus numerous other features/signs have been described to aid identification of various regional anatomic features. These include <sup>1,3</sup>:</p><ul>
-<a href="/articles/pars-bracket-sign">pars bracket sign</a>: the <a href="/articles/marginal-sulcus">marginal sulcus</a> is visible immediately posterior to the central sulcus</li>- +<a title="Upper T sign" href="/articles/upper-t-sign">upper T sign</a> or <a title="L sign" href="/articles/l-sign">L sign</a>: identifying the <a href="/articles/superior-frontal-sulcus">superior frontal sulcus</a> which intersects the <a href="/articles/precentral-sulcus">precentral sulcus</a> in a "T" or "L" junction, thus defining the <a href="/articles/precentral-gyrus">precentral gyrus</a>. The central sulcus is the next posterior sulcus. </li>
- +<li>
- +<a title="Lower T sign" href="/articles/lower-t-sign">lower T sign</a> or <a title="M sign" href="/articles/m-sign">M sign</a>: identifying the <a title="Inferior frontal sulcus" href="/articles/inferior-frontal-sulcus">inferior frontal sulcus</a>, or <a title="Inferior frontal gyrus" href="/articles/inferior-frontal-gyrus">inferior frontal gyrus</a> (which has a characteristic "M" configuration), which terminates posteriorly in the precentral sulcus and gyrus respectively. The central sulcus is the next posterior sulcus. </li>
- +<li>
- +<a title="Bracket sign of pars marginalis" href="/articles/bracket-sign-of-pars-marginalis">bracket sign</a>: the <a href="/articles/marginal-sulcus">marginal sulcus</a> is visible immediately posterior to the central sulcus, and is easily identifiable of sagittal paramedian images as the continuation of the cingulate sulcus</li>
-<a href="/articles/sigmoidal-hook-sign">sigmoidal hook sign or omega sign</a>: location of hand knob</li>-<li>intraparietal sulcus: postcentral sulcus<!--StartFragment-->- +<a title="Sigmoidal hook sign" href="/articles/sigmoidal-hook-sign">sigmoidal hook sign</a> or <a title="Omega sign of the precentral gyrus" href="/articles/omega-sign-of-the-precentral-gyrus">omega sign</a>: location of hand knob identifying the precentral gyrus</li>
- +<li>
- +<a title="bifid postcentral sulcus sign" href="/articles/bifid-postcentral-sulcus-sign">bifid postcentral sulcus sign</a>: at the medial most extent the postcentral gyrus is split by the marginal sulcus<!--StartFragment-->
-</ul><p><!--EndFragment--></p>- +<li>U sign: the most inferolateral extent of the central sulcus is capped by a "U" shaped gyrus – the subcentral gyrus – which abuts the lateral fissure</li>
- +</ul><p>Although various individuals and publications expound the virtues of one or more of these signs, the reality is that in practice one should use as many of them as possible to understand the local anatomy. In the vast majority of cases, unless there are serious congenital sulcation anomalies, prior damage (e.g. surgery) or distorting masses (e.g. tumours), the central sulcus can be identified with certainty by evaluating the region for the above features. In cases where anatomy is uncertain, or it is of critical importance to confirm the anatomy, then <a title="Functional MRI" href="/articles/functional-mri">functional MRI</a> can be performed, particularly aimed at identifying the hand motor cortex. </p><p><!--EndFragment--></p>
References changed:
- 3. Wagner M, Jurcoane A, Hattingen E. The U sign: tenth landmark to the central region on brain surface reformatted MR imaging. AJNR. American journal of neuroradiology. 34 (2): 323-6. <a href="https://doi.org/10.3174/ajnr.A3205">doi:10.3174/ajnr.A3205</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/22821920">Pubmed</a> <span class="ref_v4"></span>
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