Sulcus centralis

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 more specifically separates the primary motor cortex anteriorly from the primary somatosensory cortex posteriorly .

Radiographic features

A number of landmarks and signs have been identified as being variably useful in identifying the central sulcus on cross-sectional imaging . Although various individuals and publications expound the virtues of one or more of these signs, not all signs are present in any given patient. In practice, one should use as many of them as possible to identify the central sulcus, which is possible to do with certainty in the vast majority of cases, unless there are serious congenital sulcation anomalies, prior surgery, or distorting masses. The most well-known signs include the following:

MRI

Several central sulcus localizing signs are specific to MRI signal characteristics:

  • T1white gray sign: gray-white contrast around the central sulcus is reduced compared to precentral and postcentral sulci
  • T2: single or multiple bands of low intensity in the primary motor cortex, depending on pulse sequence and magnet strength
  • FLAIR: low signal intensity of perirolandic cortex
  • DWI: invisible cortex sign: just above the subcentral gyrus, the cortex deep to the inferolateral central sulcus appears isointense to adjacent white matter
fMRI

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.

History and etymology

The Rolandic sulcus (as it once was) was named after the Italian anatomist, Luigi Rolando (1773-1831) .

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