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  <head>
    <title>081-03 Forebrain, internal capsule, ventricles, meninges, and cerebral vascular territories</title>
    <ownerName>Integrated Medical Foundations</ownerName>
  </head>
  <body>
    <outline text="Forebrain, ventricles, meninges, and vascular territories">
      <outline text="Cortical landmarks and frontal functions">
        <outline text="Five lobes plus medial limbic region"/>
        <outline text="Central sulcus: motor front, sensory behind"/>
        <outline text="Motor map: face and arm lateral, leg medial"/>
        <outline text="Premotor and supplementary areas sequence action"/>
        <outline text="Frontal eye field: saccades to opposite side"/>
        <outline text="Dominant inferior frontal: language production"/>
        <outline text="Prefrontal: working memory, inhibition, planning"/>
      </outline>
      <outline text="Parietal, temporal, occipital cortex">
        <outline text="Superior parietal guides spatial action"/>
        <outline text="Nondominant inferior parietal attends both sides">
          <outline text="Right lesion: profound left neglect"/>
        </outline>
        <outline text="Dominant temporoparietal: comprehension, reading"/>
        <outline text="Auditory cortex receives bilateral input"/>
        <outline text="Medial temporal lobe consolidates memory"/>
        <outline text="Visual cortex around calcarine sulcus">
          <outline text="Central vision posterior"/>
          <outline text="Superior field below the sulcus"/>
        </outline>
      </outline>
      <outline text="Insula and limbic networks">
        <outline text="Insula: taste, interoception, pain salience"/>
        <outline text="Amygdala assigns emotional significance"/>
        <outline text="Hippocampus encodes contextual memory"/>
        <outline text="Hypothalamus turns motivation into output"/>
        <outline text="Distributed networks, not isolated centres"/>
      </outline>
      <outline text="White matter and internal capsule">
        <outline text="Association, commissural, projection fibres"/>
        <outline text="Corona radiata converges into capsule"/>
        <outline text="Genu: corticobulbar fibres"/>
        <outline text="Posterior limb: corticospinal and sensory"/>
        <outline text="Retrolentiform visual, sublentiform auditory"/>
        <outline text="Small deep infarct: dense deficit">
          <outline text="No aphasia, neglect or seizures"/>
        </outline>
      </outline>
      <outline text="Deep nuclei and diencephalon">
        <outline text="Basal ganglia form cortical loops"/>
        <outline text="Putamen and pallidum form lentiform nucleus"/>
        <outline text="Capsule between thalamus or caudate and lentiform">
          <outline text="Deep perforator lesions hit motor pathways"/>
        </outline>
        <outline text="Thalamus relays to cortex"/>
        <outline text="Hypothalamus regulates homeostasis"/>
      </outline>
      <outline text="Ventricles and hydrocephalus">
        <outline text="Lateral, third, aqueduct, fourth ventricle"/>
        <outline text="Choroid plexus secretes most fluid"/>
        <outline text="Absorbed via granulations and lymphatics"/>
        <outline text="Obstruction: noncommunicating, upstream dilation"/>
        <outline text="Poor absorption: communicating"/>
        <outline text="Raised pressure: headache, papilloedema, sixth nerve"/>
        <outline text="Distinguish from ex-vacuo enlargement"/>
        <outline text="Normal-pressure hydrocephalus triad imperfect"/>
      </outline>
      <outline text="Meninges and haemorrhage">
        <outline text="Dural layers separate to form sinuses"/>
        <outline text="Folds: falx, tentorium, diaphragma sellae"/>
        <outline text="Subarachnoid space holds fluid and vessels"/>
        <outline text="Meningeal irritation: headache, neck stiffness"/>
        <outline text="Epidural: arterial, limited by sutures"/>
        <outline text="Subdural: bridging veins, crosses sutures"/>
        <outline text="Subarachnoid blood disperses through cisterns"/>
      </outline>
      <outline text="Arterial territories and strokes">
        <outline text="Circle of Willis links carotid and vertebrobasilar"/>
        <outline text="Anterior cerebral: medial surface, leg">
          <outline text="Leg-predominant weakness, abulia, bladder"/>
        </outline>
        <outline text="Middle cerebral: lateral hemisphere, deep">
          <outline text="Face-arm deficit, aphasia or neglect"/>
        </outline>
        <outline text="Posterior cerebral: occipital, thalamus, midbrain">
          <outline text="Contralateral homonymous hemianopia"/>
        </outline>
        <outline text="Deep perforators are end arteries">
          <outline text="Lipohyalinosis occludes, hypertension ruptures"/>
          <outline text="Lacunar syndromes"/>
        </outline>
        <outline text="Emboli lodge at branch points"/>
        <outline text="Watershed infarcts in severe hypoperfusion"/>
      </outline>
      <outline text="Venous drainage">
        <outline text="Superficial veins to superior sagittal sinus"/>
        <outline text="Deep veins to straight sinus"/>
        <outline text="Sigmoid sinuses to internal jugular veins"/>
        <outline text="Emissary veins can transmit infection"/>
        <outline text="Outflow block raises capillary pressure">
          <outline text="Oedema, haemorrhage, intracranial hypertension"/>
        </outline>
        <outline text="Venous infarcts ignore arterial territories"/>
      </outline>
      <outline text="Herniation and localisation">
        <outline text="Fixed skull volume limits compensation"/>
        <outline text="Subfalcine: may compress anterior cerebral"/>
        <outline text="Uncal: third nerve, posterior cerebral, peduncle"/>
        <outline text="Tonsillar threatens medullary centres"/>
        <outline text="Cortical signs point to cortex"/>
        <outline text="Dense deficit without them: deep or brainstem"/>
      </outline>
    </outline>
  </body>
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