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Cistern of lateral cerebral fossa

The cistern of the lateral cerebral fossa, commonly known as the Sylvian cistern, is a prominent cerebrospinal fluid (CSF)-filled space located along the lateral surface of the cerebral hemispheres. It lies deep to the Sylvian (lateral) fissure, separating the frontal and temporal lobes. The cistern contains important vascular structures such as the middle cerebral artery (MCA), its branches, veins, and cranial nerves. It serves as a crucial anatomical landmark in neuroimaging and neurosurgery due to its content and location.

Synonyms

  • Sylvian cistern

  • Cistern of the lateral cerebral fossa

  • Fossa lateralis cerebri cistern

  • Lateral fissure cistern

Function

  • CSF Reservoir: Acts as a CSF-filled space, providing cushioning and protection for the brain structures.

  • Vascular Conduit: Houses and protects the middle cerebral artery (MCA) and its branches, along with associated veins.

  • Surgical Landmark: Used as a key anatomical reference in neurosurgical approaches to lesions near the Sylvian fissure.

  • Pathway for Cranial Nerves: Contains segments of the trigeminal and facial nerves as they pass through the subarachnoid space.

MRI Appearance

  • T1-weighted MRI:

    • The Sylvian cistern appears as a dark (hypointense) CSF-filled space compared to the brain parenchyma.

    • The contained vessels may be seen as flow voids or signal loss.

  • T2-weighted MRI:

    • CSF within the Sylvian cistern appears very bright (hyperintense), clearly demarcating the cistern from surrounding gray and white matter.

    • Vessels within the cistern show as flow voids (dark tubular structures).

  • FLAIR (Fluid Attenuated Inversion Recovery):

    • The cistern is typically dark (hypointense) because normal CSF signal is suppressed.

    • Any abnormal content (blood, pus, tumor) within the cistern may appear as hyperintense (bright), making pathology detection easier.

CT Appearance

  • Non-contrast CT:

    • The Sylvian cistern is seen as a low-density (dark/black) area between the frontal and temporal lobes, conforming to the shape of the lateral fissure.

    • Acute blood, if present (e.g., in subarachnoid hemorrhage), will appear hyperdense (white) within the cistern.

    • Effacement or loss of the cistern’s visibility may indicate mass effect from adjacent edema, tumor, or hemorrhage.

MRI images

cistern of lateral cerebral fossa (Sylvian cistern) mri 3t coronal image

CT image

Cistern of lateral cerebral fossa (Sylvian cistern) CT axial anatomy image -img-00001-00001