Umair Rashid Chaudhry, M Usman Ghani.
Localization of Central Sulcus.
Pak J Neurol Jan ;6(1-2):25-9.

Objectives: To evaluate the different commonly described signs for localizing the central sulcus and related gyri in axial plain CT. Methodology: Our study included 1000 normal and 200 abnormal CT scans of either sex of all age groups. The CT scans used for the study were obtained on a Somatom DRH Siemens as serial 4 mm / 8 mm thick sections oriented parallel to the skull base. The direct and indirect cortical methods were assessed to localized the central sulcus. Start localizing the central sulcus from anterior to posterior with relation to other sulci, including the anatomic relationships among (1) superior frontal sulcus and the precentral sulcus (SFS connected with precentral sulcus - SFS - CS sign); (2) the pars marginalis and the central sulcus; (PM medial and posterior to medial end of central sulcus - Pars Bracket sign); (3) pars marginalis and the postcentral sulcus; (Bifid PCS enclose / approaches the lateral end of the PM - bifid post CS sign); (4) the central sulcus and interhemispheric fissure (CS reaches the interhemispheric fissure - midline sulcus sign) (IFH). (5) Precentral gyrus thickness compare to post central gyrus. (6) Thick precentral gyrus (cortical thickness sign). (7) sigmoidal shape (hook / knob like) of posterior bend of central sulcus, which are the DIRECT cortical sign for localizing the central sulcus. Results: No single sign was 100% effective. The relationship 1, 2, 3, 5, and 7 proved to be most reliable and quite effective signs. Conclusion: Correct identification of the central. sulcus and adjacent gyri is essential for localizing pathology and planning effective therapy. Each description of a "sign" assumes that the anatomy of the brain- remains constant. Anatomic variability necessarily limits the accuracy and utility of each described sign. But use of all signs together provides a holistic understanding of the cortical anatomy of the central region, permitting correct identification of the misnomer frontoparietal region anatomy in nearly all cases.

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