Internal capsule

Most IC lesions are caused by vascular accidents (thrombosis orhemorrhage).

1. anterior choroidal: ⇒ all of retrolenticular part (includes optic radiation) and ventral part of the posterior limb of IC

2. lateral striate branches (AKA capsular branches) of middle cerebral artery: ⇒ most of the anterior AND posterior limbs of IC

3. genu usually receives some direct branches of the internal carotid artery.

As a general rule, the internal capsule and its vascularization should be seen as a parasagittal barrier with great functional importance. This is of particular importance in choosing surgical approaches within this region ¹⁾.

Area of white matter in the brain that separates the caudate nucleus and the thalamus from the putamen and the globus pallidus. The internal capsule contains both ascending and descending axons.

It consists of axonal fibres that run between the cerebral cortex and the pyramids of the medulla.

The internal capsule is V-shaped when cut transversely (horizontally).

When cut horizontally:

the bend in the V is called the genu

Anterior limb of the internal capsule.

Posterior limb of the internal capsule.

the retrolenticular portion is caudal to the lenticular nucleus and carries optic tracts including the geniculocalcarine radiations.

the sublenticular portion is beneath the lenticular nucleus and are tracts involved in the auditory pathway from medial geniculate nucleus to the primary auditory cortex (Brodmann Area 41).

Gross motor strength is impaired with ischemia of the internal capsule.

A study was performed to establish an accurate internal capsule (IC) target for capsular stroke modeling in rats.

Song et al., injected adeno-associated virus serotype 5 (AAV)-CaMKII-EYFP into forelimb motor cortex and AAV-CaMKII-mCherry into hindlimb motor cortex (n = 9) to anterogradely trace the pyramidal fibers and map their somatotopic distribution in the IC. On the basis of the neural tracing results, we created photothrombotic infarct lesions in rat forelimb and hindlimb motor fiber (FMF and HMF) areas of the IC (n = 29) and assessed motor behavior using a forelimb-use asymmetry test, a foot-fault test, and a single-pellet reaching test. We found that the FMFs and HMFs were primarily distributed in the inferior portion of the posterior limb of the IC, with the FMFs located largely ventral to the HMFs but with an area of partial overlap. Photothrombotic lesions in the FMF area resulted in persistent motor deficits. In contrast, lesions in the HMF area did not result in persistent motor deficits. These results indicate that identification of the somatotopic distribution of pyramidal fibers is critical for accurate targeting in animal capsular stroke models: only infarcts in the FMF area resulted in long-lasting motor deficits ²⁾.