Superior frontal gyrus

Eloquence

• Its posterior portion lies near motor cortex, which Sawaya's grading treats as near-eloquent territory. (Sawaya et al. 1998)

What it does

• Its posterior medial portion contains the supplementary motor area. (Laplane et al. 1977; Fontaine et al. 2002)

Arterial supply

• Supplied mainly by branches of the anterior cerebral artery; its lateral margin borders middle cerebral artery territory. (Tatu et al. 1998)

Venous drainage

• Drained by superficial cortical veins to the superior sagittal sinus. (Rhoton 2002)

Deficits if injured

• Resection involving the supplementary motor area can cause a syndrome of contralateral akinesia and, when the dominant hemisphere (usually left) is involved, reduced speech output; it usually recovers. (Laplane et al. 1977; Fontaine et al. 2002; Krainik et al. 2003)

Surgical relevance

• Deficits after supplementary motor area resection are typically transient, unlike deficits from injury to primary motor cortex or the corticospinal tract. (Laplane et al. 1977; Fontaine et al. 2002; Keles et al. 2004)

On the template

Desikan-Killiany. Values describe the fsaverage template, not an individual or a population norm.

Area: pial surface of the fsaverage average, which is smoother than individual cortex. Volume: voxel count of the fsaverage aseg segmentation at 1 mm isotropic.

References

1. Sawaya R, Hammoud M, Schoppa D, Hess KR, Wu SZ, Shi WM, et al.. Neurosurgical Outcomes in a Modern Series of 400 Craniotomies for Treatment of Parenchymal Tumors. Neurosurgery 1998;42(5):1044-1055. doi:10.1097/00006123-199805000-00054
2. Laplane D, Talairach J, Meininger V, Bancaud J, Orgogozo JM. Clinical consequences of corticectomies involving the supplementary motor area in man. Journal of the Neurological Sciences 1977;34(3):301-314. doi:10.1016/0022-510X(77)90148-4
3. Fontaine D, Capelle L, Duffau H. Somatotopy of the Supplementary Motor Area: Evidence from Correlation of the Extent of Surgical Resection with the Clinical Patterns of Deficit. Neurosurgery 2002;50(2):297-305. doi:10.1097/00006123-200202000-00011
4. Tatu L, Moulin T, Bogousslavsky J, Duvernoy H. Arterial territories of the human brain. Neurology 1998;50(6):1699-1708. doi:10.1212/WNL.50.6.1699
5. Rhoton AL. The Cerebral Veins. Neurosurgery 2002;51(suppl_4):S1-159-S1-205. doi:10.1097/00006123-200210001-00005
6. Krainik A, Lehéricy S, Duffau H, Capelle L, Chainay H, Cornu P, et al.. Postoperative speech disorder after medial frontal surgery. Neurology 2003;60(4):587-594. doi:10.1212/01.WNL.0000048206.07837.59
7. Keles GE, Lundin DA, Lamborn KR, Chang EF, Ojemann G, Berger MS. Intraoperative subcortical stimulation mapping for hemispheric perirolandic gliomas located within or adjacent to the descending motor pathways: evaluation of morbidity and assessment of functional outcome in 294 patients. Journal of Neurosurgery 2004;100(3):369-375. doi:10.3171/jns.2004.100.3.0369