VA Mid-Atlantic Health Care Network

Windows to the Brain:

Introduction to Neuroanatomy
Overview
Planes of Section
Radiographic Perspective
Major Divisions
Cortical
Lobes, Gyri & Sulci
General Functions
Brodmann’s Areas
Basal Forebrain
Subcortical
Structures
Symptoms
Cerebellum
Structures
Symptoms

Katherine Taber, PhD, FANPA

MIRECC Assistant Director - Education
Research Health Scientist
W.G. “Bill” Hefner VAMC, Salisbury NC
Research Professor, Div Biomedical Sciences
Edward Via College of Osteopathic Medicine

Robin Hurley, MD, FANPA

MIRECC Associate Director - Education
ACOS/Research and Academic Affairs Service Line
W.G. “Bill” Hefner VAMC, Salisbury NC
Professor, Psychiatry and Radiology
Wake Forest School of Medicine

revised September 2019

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1
 Planes of Section

In medical practice the most Lateral View

common way to view the brain is Superior
the two dimensional sections

Posterior
Anterior
provided by magnetic resonance
axial plane of section
imaging (MRI) and computed
tomography (CT). While it is
possible to image the brain in
coronal plane of section
virtually any orientation, the axial
plane of section is used most
often as it allows the entire brain
to be captured in the fewest
number of sections. Anatomists Inferior
prefer the coronal plane of section
because many structures, Inferior (Bottom) View
particularly small ones, are more
easily recognized. Note that both

Posterior
the axial and sagittal planes of Anterior sagittal plane of section
section go from the front (anterior)
to the back (posterior) of the brain.
Axial goes from one side to the
Medial
other (medial to lateral). Sagittal
goes from top (superior) to bottom
(inferior). coronal plane of section

Lateral

axial plane of section sagittal plane of section coronal plane of section

2
 Radiographic Perspective
Clinical images are displayed in the radiographic perspective. Most teaching and
reference materials use the anatomic perspective.

All radiographic images are displayed using a single set of conventions:

patient is lying on his/her back (supine) patient’s patient’s
right left
viewer is at patient’s feet
looking toward the
patient’s head

viewer
There are 2 key differences between the radiographic perspective and the
anatomic perspective that are important to remember when viewing clinical brain
images.

[1] The left side of an axial or coronal brain image is the right side of the brain:
R L R L
patient’s patient’s
right left

viewer

[2] On axial images brainstem and spinal cord will be inverted compared to how
they are displayed in most teaching and reference materials:

3
 Major Divisions
Major Divisions
The neural tube (illustrated in schematic form) expands locally to form the 3
primary divisions or vesicles: forebrain (prosencephalon, yellow), midbrain
(mesencephalon, green), and hindbrain (rhombencephalon, purple). These in
turn form the 5 secondary divisions. The forebrain vesicle subdivides into
telencephalon (yellow) and diencephalon (light green). The hindbrain vesicle
subdivides into the metencephalon (blue) and myelencephalon (pink). *
Primary Secondary Final Areas Formed
Divisions Divisions
forebrain telencephalon c e r e b r a l h e m i s p h e r e s , l i m b i c s ys t e m ,
(prosencephalon) basal ganglia
diencephalon t h a l a m u s , h yp o t h a l a m u s , e p i t h a l a m u s ,
midbrain s u b t h a l a m u s , o p t i c ve s i c l e
(mesencephalon)

mesencephalon superior & inferior colliculi, red nucleus,

hindbrain s u b s ta n ti a n i g r a , p e r i a q u e d u c ta l g r a y
(rhombencephalon) metencephalon pons, cerebellum

m ye l e n c e p h a l o n medulla

spinal cord
spinal cord

z
Inferior (Bottom) View
The 5 secondary divisions are
color-coded onto magnetic
resonance images to provide cerebral cortex
overall orientation.
pons
medulla

cerebellum

Midline Medial (Parasagittal) View Lateral View

cerebral cortex
cerebral cortex
corpus callosum
diencephalon
midbrain
pons cerebellum pons
cerebellum
medulla medulla

*Taber KH, Salpekar J, Wong AHC, Hurley RA. J Neuropsychiatry Clin Neurosci 2011;23(1): 1-5.

4
 Cerebral Cortex - Lobes
Midline Medial (Parasagittal) View Lateral View

parietal
frontal
parietal
limbic
frontal
occipital
occipital
temporal

parietal
frontal
limbic parietal
frontal

occipital
occipital

temporal temporal
Medial Orbital

Inferior (Bottom) View

The highly in-folded cerebral cortex is
the largest single division of the
human brain. Anatomists commonly temporal
occipital
divide it into four sections or lobes - frontal
the frontal, temporal, parietal and limbic
occipital lobes. Some consider the
limbic areas of cortex to comprise a
fifth lobe, whereas others include
these areas in the frontal and
temporal lobes and diencephalon.
Note that the medial and posterior
inferior surfaces of the temporal lobe Lateral
can only be seen on the drawings of temporal
the medial and inferior surfaces of the
brain. This is because the brainstem frontal occipital
and cerebellum have been omitted on
the drawings. limbic parietal
Medial

5
 Major Gyri & Sulci
Midline Medial (Parasagittal) View Lateral View
Central
Central (Rolandic) Sulcus (Rolandic)

l
tra
Sulcus

l
tra
en
Paracentra l P Parietooccipital l Su
nta

en
re
Pa per

ec
lobule cu Sulcus ro ta l

stc
ta l ne F i
on Lo riet or

Pr
ron r
us
Fr

Po
bu a l
rF

dd o
ri
Cingulate le

le
pe
Calcarine
rio

Anrginal
ra ma

Su

Fro or
Sulcus
pe

Sup

gu
Cuneus

Mi

l
eri
nta
Subcentral
Su

la r
ora

Inf
p
Ling
ua l Tem ra l
O ccipital
r i or po
pe m
Su Te ra l
O rbital le po
Gyrus Rectus
i dd r Tem
M rio
e
Inf
O rbital
Sylvian Fissure
(Lateral Sulcus)
Central
Central (Rolandic) Sulcus (Rolandic)
Sulcus
Paracentra l
ta l

en l
ta l Pa Su

l
ron Pr Parietooccipital on

tra
Po entr
F lobule ec r rie pe
r un
eu
Sulcus
rF ta l t r
An a l L ior
on

ec
Cingulate
rio

stc
rio
r gu ob

Pr
F
pe

la r ul

pe
e

le
Calcarine
Su

ma

Su
Subcallosal ra

dd

Fro rior
Cuneus Sulcus

Sup

rgina l
(Paraolfactory)

l
Mi

nta
Area

e
Hippocampus Subcentral
al O ccipital

Inf
al Ling m por
Uncus mp
a ua l rTe al
poc erio por
Gyrus Rectus Pa ra hip Sup Te m
rm a l
Fusifo dle pora
l
por M id r Tem
Inferior T m
e Sylvian Fissure
Infe
rio
(Lateral Sulcus)

frontal temporal parietal occipital limbic

Inferior (Bottom) View
l
Posterior O rbital
al mpora
La ter a l Te
O rbit rior
Infe
Anterior rm
O rbital Fusifo
An outfolding of the cerebral
cortex is called a gyrus Medial O rbital
Parahippocampal
Gyrus Rectus
(plural is gyri), an infolding is Uncus
called a sulcus (plural is
sulci). Some very large sulci
are called fissures. Although
major gyri and sulci are
present in all normal brains, Sylvian Fissure
they can vary considerably in (Lateral Sulcus)
Infer
both extent and location. Fusif
ior Te
mpor
Lateral al al
Many areas have La ter a l orm
O rbit
considerable normal AnteriorPosterior
O rbital O rbital hip
Pa ra poca mp
variation in the folding Medial O rbital Uncus al
Gyrus Rectus
patterns. Medial

7
 Major Functions
Right Hemisphere
Medial (Parasagittal) View Lateral View
Somatosensory Motor
Initiation
Motor & Synchronization Hip
Sensory Initiation
Somatosensory of Speech Integration & Arm
Leg
& Synchronization
& Complex Focused Attention, Recognition of Speech
Hand
Movements N onverbal Intellect & Complex
Sensory Integration & Foot & N onverbal Hand
Movements
Recognition Memory Audiovisual
Management Face Focused Attention,
Awareness &
Deficit Recognition N onverbal Intellect
Visual Face & N onverbal
O rientation, Music & Voice Tongue Speech Memory
Recognition Prosody &
Guidance &
Scanning
Hearing Gesturing Management

Visuospacial
Smell Social Conduct, Recognition
Visuospacial Insight & Seeing N aming
Recognition Judgment
N aming Visual O rientation, Social Conduct,
Seeing, Color Vision, Guidance & Scanning Insight & Judgment
& W hole O bject
Imaging
Inferior (Bottom) View
Right Hemisphere - In most Retrograde N Lateral
individuals, the processing of Visuospacial Episodic a ming
Recognition Memory
nonverbal information, such as Social
N onverbal
music or visuospatial information, Seeing,
Color Vision, Memory Conduct,
& Emotion Insight &
occurs primarily in the right & Smell Judgment
W hole O bject
hemisphere. Imaging

frontal temporal parietal occipital limbic Medial

Left Hemisphere
Medial (Parasagittal) View Lateral View
Motor Somatosensory
Initiation & Motor Somatosensory Hip
Focused Initiation &
Attention, Synchronization Synchronization Arm
Verbal Intellect of Speech Leg
Leg of Speech Sensory Integration
& Complex Hand & Recognition
& Verbal & Complex
Movement Foot Foot Movement
Memory Sensory Integration
SmVis rsu

Hand Hand ing

ooua l it

& Recognition nd riting To

Pu

Management
th

Focused
Hand
ersta W Dictation
Face Face d
Attention, UnVerbalReading Aloud
Verbal Intellect Face Face Repetition Spelling
Visual & Verbal Speech
O rientation, Speaking Tongue
Memory Hearing
Guidance & Management
Scanning Visual
Recognition
Social Conduct, Smell
Insight & Visual N aming
Recognition Seeing
Judgment Social
Conduct, Visual O rientation,
N aming Seeing, Color Vision & Insight & Guidance & Scanning
W hole O bject Imaging Judgment

Inferior (Bottom) View

Lateral
Left Hemisphere - In most N aming
individuals, the processing of Visuospacial
Recognition
verbal information, including Social Verbal Memory
Seeing,
Conduct, & Emotion
language, occurs primarily in the Insight &
Smell
Color Vision
&
left hemisphere. Judgment
W hole O bject
Imaging

frontal temporal parietal occipital limbic Medial

8
 Brodmann’s Areas
In the early part of the 20th century, Brodmann defined cortical areas based upon features
such as the size, shape and distribution of neurons (cytoarchitecture). An approximation of
these areas are provided in the illustrations below. Versions of this system are still widely
used. While useful, it is important to always keep in mind that Brodmann’s work was based
upon analysis of a single brain. Brains vary greatly in size, shape, and infolding patterns.
Research has shown that there is a wide range in the extent of a specific Brodmann area
when compared across individuals. Thus, such maps should be used only as extremely
general guides.
Lateral View
limbic temporal occipital parietal frontal 44 4 4 4 312
6 6 4 4 4 4 31 5 5
6
6 6 6 6 4 4 4 2 5 5 77
6 6 6 4 4 3 1 5 7 7 7
6 66 6 6 6 6 4 44 4 5 7
6
8 8 8 8 6 6 6 4 44 4 4
3 1 2 5 7 7 7 7 7
6 5 7 7 7 7
8 88 8 6 1
8 88 8 8 8 66 6 4 4 3 2 40 7 7 7 7 7 77 7
9 9 9 8 8 6 4 4 12 7 7 7
9 9 9 9 9 8 6 6 4 40 40 7 19
9 9 8 8 6 6 6 4 3 31 40 7 7 7 19
9 9 9 9 2 7 19
9 9 9 9 9 9 8 8 8 66 643 1 1 40 40 40 39 7
19 19
9 9 9 9 9 8 8 6 664 2
40 40
40 39 19
9 9 9 9 9 9 9 3 1 1 40 39 19 19 19
9 4 2 40
10 10 10 46 46 9 9 9 6 6 6 3 40 40 40
19
40 39 39 19 19 19 19
46 9 6 4 1 1 39
10 10 10 46 46 9 9 9 9 6 2 40 39 19 19 19 18
46 45 44 44 6 4 3 1 1 40 40 22 39 19
10 46 46 40 19 18
10 10 45 45 6 4 1 2 40 40 22
22 39 39 19 18
46 46 46 44 44 6 40 22 2137 39 19 19 18 18
10 10 45 45 64 3 40 40 22 39 17
1 2
10 46 46 46 45 44 6 52 42 22 21 3737 19 19
10 10 46 46 4545
45 45 44 6 4433 43 52415241 41 22 37 18 18 1717
45 44 6 41 42 42 22 21 37 19 18
10 44 42 42
10 10 46 45 4545 45 45 44 22 22 22 22 2222 21 37 19 19 19 18 17 17
45 22 22 22 18
10 10 10 45 45 45 45 44 38 22 22 22 22 22 21 21 37 19 1919 18 17
10 10 47 45 45 45 45 38 22 22 21 37 19 19 19 18
10 38 38 22 21 21 37
11 11
47
47
45 45 38 38 21 21 21
21 21 19 19 1919
11
11 11 11 11 47 45 38 38 21 21 21 37 37 37 37 19
11 11 1147 47 38 38 21 21 21 21 37
11 38 21 21 21 37
38 21 21 21 20
38 21 21 21 21 21 21 20
38 20 20
38 38 21 20
20
38 38 20 20
38 20 20
20 20

Medial (Parasagittal) View

4 4 4
frontal temporal parietal occipital limbic 6 6 44 4
6 6 4 4 4 4 33 1 2
6 66 6
6 4 4 4 4 11 5 5
6 6 6 6 4 4 4 4 3112 5 7
6 6 6 4 4 4 5 5 7
6 6 6 4 4 12 7 7
8
8 6 6 6 6 6 6 6 4 4 4 4 4 31 5 5 5 7 7
8 6 4 4 4 5 7 7
8 8 8 68 6 6 6 6 6 4 4 4 3 12
5 777
6 4 7 7 7 7
9 8 8 8 8 8 6
6 6 6 4 4 45 5 5 5 7
5
7 7 77 7
8 8
9 9 32 32 6 6 6 4 4 4 31 31 7 7 7 7
7 77
9 9 9 32 32 32 6 6 4 4 4 5 5 31 31 31
31 7
9 32 32 32 32 32 24 4 4 4 31 7 7 7 19
9 9
9 32 32 32 24 24 31 31 31
31 31 31 31
31 19
9 32 31 31 31
9
9 9 32 32 24 24 24 24
24 24 23
23 23 31 31 31 31 181919 19
23 23
9 9 9 9 32 32 24 24 23 23 23 23 23 31 31 31 19
32 24 23 23 23 31 18 18 18 19
9 9 9 32 32 24 33 33 30 31 18 18
9 29 2323 18 18 18
9 9 9 32 32 2433 262930 18 18 18 18 18
10 9 32 32 32 33 293023 18 18 18 17
10 32 263023 17 17 17 17
10 32 2433 2923 17 17 17 17 17
32 32 32 2930 17 17
32 24 3324 25 18 17
10 10 32 34 2630
19 18 18 17
17
10 32 25 34 34 27 30 35 17 17 17
10 10 10 10 32 25 36 34 34 27 35 19 19 18
10 12 12 12 12 25 38 28 34 27 27 2728 27 35 37 19
19
18 18
10 10 12 12 36 28 27 28 35 37 19 19 19 19 18
12 12 12 12 25 38 28 28 28 28 35 35 35 37 37 19 19 19 19
12 12 12 11 38
36 28 28 28 36 37
11 11 11 11 11 28 28 36 36 36 35 35 37 37 37
38 36 36 36 36 20 37 37 37 19
37 37
38 38 36 20
36 36 20
38 20 20 37
38 20 20 20 20 20
20 20 20 20

9
 Basal Forebrain
The basal forebrain area contains many cholinergic neurons in the basal nucleus
of Meynert, nucleus of the diagonal band and septal nuclei. The general location
of this important region Sagittal Brain Section
and its projections to
cortex are approximated
on sagittal and coronal
magnetic resonance
images. The basal
forebrain cholinergic
neurons project to cortex
via both medial and
lateral routes. Fibers
travel to hippocampus
via the fornix, olfactory
cortex via the olfactory
tract and amydala via
stria terminalis and the
ventral amygdalofugal
pathway.
basal forebrain region
Coronal Brain Sections
septal nuclei
lateral pathways
lateral pathways

medial pathway
nucleus diagonal band amygdala
basal nucleus

10
 Major Subcortical Structures
A brief guide to neuropsychiatric symptoms associated with injury to each of the
major subcortical structures is color-coded to match the illustration on the
previous page.

Thalamus - (left) deficits in language, verbal intellect, and verbal memory

(right) deficits in visuospatial and nonverbal intellect and visual memory,
(bilateral) severe memory impairment (“thalamic amnesia”) as well as
dementia; damage to the anterior and medial thalamus can also result in
disturbances of autonomic functions, mood, and the sleep/waking cycle.

Caudate - apathy, disinhibition, disorganization, executive dysfunction,

depression, memory loss, atypical aphasia, psychosis, personality changes,
and predisposition for delirium.

Putamen - most commonly language and behavioral deficits (i.e., atypical

aphasia, obsessive - compulsive traits, executive dysfunction); hemineglect,
depression, and memory loss have also been reported.

Globus pallidus - anxiety, depression, apathy, psychosis, and central pain;

less often reported symptoms include amnesia and cognitive deficits.

Amygdala - passivity or aggression, hypersexuality, hyperorality,

hyperphagia, decreased fear, anxiety or startle, and decreased link between
emotion and memory.

Hippocampal formation - primarily memory deficits including

anterograde and retrograde amnesia, inability to form new memories, and
temporally graded amnesia.

Fornix - memory deficits include impaired recent memory, syndrome of

transitory amnesia, and long-term anterograde amnesia.

Hypothalamus - aggression, violence, anorexia, depression, impaired

short-term memory, dementia, gelastic seizures, and altered sleep/wake cycle.

Mammillary body - memory deficits and psychosis.

Substantia nigra - primarily behavioral and emotional deficits (i.e.,
apraxia, ataxia, aggression, and depression), with less frequent reports of
memory and cognitive deficits.

12