A handy tool to teach microneurosurgical anatomy of uncus

Background Detailed anatomical knowledge of the parahippocampal gyrus and uncus is paramount to neurosurgeons. Mesial temporal and limbic anatomy are an integral part of the microneurosurgical anatomy curriculum for neurosurgical residents around the world. It is intricate, detailed anatomy and several tools have been used to ease the learning curve on this subject. This paper presents a simple, low-technological mnemonics and frame-model to help learn the microsurgical anatomy of the uncus. Methods Microsurgical anatomy of the uncus is presented using cadaveric specimens placed side-by-side to views of the right hand with fingers flexed and the wrist adducted. Results By holding the right hand with fingers and wrist flexed, a resemblance of the uncal morphology can be appreciated. The index and second fingers represent the two gyri on the anterior surface of the uncus. The index resembles the semilunar gyrus, the second finger stands for the ambient gyrus, while the space between them accounts for the semianular sulcus (sulcus semiannularis). The three following fingers represent the uncal morphology seen once the parahippocampal lip is removed, by working through the uncal sulcus. The middle finger is the uncinated gyrus, the annular finger, represents the band of Giacomini and the pinky finger represents the intralimbic gyrus. Conclusion A “handy,” portable reminder of the microsurgical anatomy of the uncus - a required milestone in neurosurgery – is presented.