Age-Dependent Changes of the Sylvian Fissure Configuration

Abstract

Objective: To investigate age-related morphological changes of the Sylvian fissure (SF) and their implications for neurosurgical procedures.

Methods: A cohort of 150 individuals across the age groups 10-20, 40-50, and 80-90 years was analyzed using Brainlab software for 3-dimensional visualization and volumetric analysis of the SF and various brain regions. We compared SF volumes between age groups and investigated dynamic changes in SF configuration over time. Correlation analyses were performed to identify how atrophy in specific brain regions affects the SF volume and configuration.

Results: Atrophy was evident in all measured regions of the brain. The frontoparietal lobe underwent the strongest atrophy, while the occipital lobe showed the least. Each age group exhibited a consistent distribution of lobe volumes, although a marginal decrease in frontoparietal lobe proportion was observed in the groups of higher age. The annual atrophy rate in the frontoparietal and temporal lobes was steady. Additionally, ventricular expansion, which may influence white matter atrophy patterns, correlated with age. A consistent increase in SF volume in relation to the intracranial volume was observed across all age groups, with a notable increase in SF volume in older patients. This expansion, especially at the anterior-superior point, might be influenced by gravity, cerebral elasticity, and lobe torque.

Conclusions: Our investigation highlights the significance of age-dependent changes in SF volume and configuration due to brain atrophy throughout life. These changes, influenced by physical factors, underscore the need for tailored surgical approaches. Additionally, brain pathologies affecting volume could significantly alter SF configuration.

Keywords: 3D visualization; Age-related morphological changes; Brain atrophy; Brainlab software; Preoperative planning; Sylvian fissure; Volumetric analysis.