Neuroanatomy of internal capsule

1. Internal Capsule
• Neuroanatomy
• Blood supply
Guide: Dr Praveen Kusabi
Student: Dr Kiran Revankar

2. Grey Matter
White Matter

3. Association Fibers Projection FibersCommisural Fibers

4. Association Fibers

5. Commissural Fibers

6. Projection Fibers

7. I
N
T
E
R
N
A
L
C
A
P
S
U
L
E
LN
Lenticular
nucleus

8. 1
2
3
4
5
1. Anterior
2. Genu
3. posterior
4. Retro lenticular
5. Sub lenticular

9. Caudate Nucleus
Thalamus
Lentiform nucleus
(Globus pallidus + Putamen)

10. F
A
T
L
Anterior thalamic radiation
Superior thalamic radiation
Posterior thalamic radiation
Inferior thalamic radiation
Fronto Pontine Fibers
Cortico Pontine
Fibers
Cortico Bulbar tracts
Cortico spinal tracts
Motor Sensory

13. SL
AL
G
PL
MCA
ACA
ICA
PCAB
A
S
I
L
A
r
A. choroidal
Blood Supply

17. Clinical Significance
Parietal lobe
Face and arm
Aphasia (brocas)
Agnosias/apraxias
Pie in the floor
Temporal lobe
Aphasia (wernickes)
Behavioural disturbances
Pie in the sky
Memory
Lacunar infarct(0.5mm to 15)
Pure Motor involvement

18. Collapse or Rupture
Microaneurysms
Week artery wall
Lipohyalinosis
Hypertension

19. ACA Involvement
Leg>>Arm
Urinary Incontinence
Memory /Emotional Disturbance
Anterior disconnection syndrome
(left arm apraxia)
Sylvian fissure

20. ACA MCA
Medial Lateral
Lenticulo – Striate artery

21. The Anterior choroidal artery syndrome
• Hemiparesis caused by involvement of the posterior limb of the internal capsule
• Hemisensory loss caused by involvement of thalamocortical fibers
• Hemianopia secondary to involvement of the lateral geniculate body

22. Watershed Ischemic Syndromes
• Ischemic lesions in an area between two neighbouring vascular territories
• Mostly bilateral / secondary to hypo perfusion eg: cardiac arrest/hypotension/major surgeries

28. Thank you