Providing Specialized Tractography for the Memory Circuitry of the Brain

Fornix Tractography

About Fornix Tractography

The fornix is a highly specialized structure deep in the brain, recently revealed by detailed DTI tractography.  The fornix is, unfortunately, subjected to the worst possible forces during an impact injury to the head.  Anteriorly (the front part) is embedded in solid brain tissue, called the pillars, the body of the fornix then passes through the liquid of the ventricles of the brain, and finally splits into the right and left crus back into solid brain tissue.  This anatomy leaves the fornix strung through liquid between two solid structures that can shift during an impact severely injuring this small but critical set of brain fibers.

Many patients who have had mild concussion, TBI, or other head impact may suffer unexplained short-term memory loss. There is no large injury such as hematoma and the patient may recover from headaches or dizziness but they are still left with an extremely difficult situation of memory impairment that impacts educational, work, and daily activities.  Because of Dr. Aaron Filler’s work with DTI and his eagerness to improve imaging he has developed a technique to evaluate this small structure with tractography and fractional anisotropy.

More detailed information

Photo on the right – Left lateral view of a limbic system tractogram. The lowest tract is the hippocampal cingulum (HC) which can be inspected for tract losses indicating problems with attention and concentration. This arcs up to the supra-callosal cingulum (SC) above the corpus callosum where anterior injury observed by inspection will indicate a basis for increased anxiety and depression. The second strip from the bottom is the fimbria fornix and stria terminalis (FF-ST) which arch upwards through  the crus of the fornix (CF) and reach the midline descending pillars of the fornix anteriorly (PF). Injuries in the fornix will result in impairment in new memory formation capabilities. At the inferior margin of the anterior pillars of the fornix there is a split to an anterior portion projecting to the anterior septal nucleus, reaching above the anterior commissure and a posteriorly directed portion. After a head injury, the neurosurgeon may now inspect the various tracts of the brain in conjunction with an exam and interview in order to assess possible locations of injury.

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