Medial Cerebral Sulci Variability for Surgical Corridors: A Scoping Review of Cadaveric Evidence

Introduction: Medial sulci are key intraoperative landmarks and radiologic boundaries that determine safe interhemispheric approaches and accurate Magnetic Resonance Imaging (MRI) interpretations. The cingulate, paracingulate, calcarine, parietooccipital, callosal, rostral, supra-rostral, and subparietal sulci are the principal surgical corridors and radiologic boundaries on the medial surface. These structures serve as essential neuroanatomical landmarks and surgical corridors in micro neurosurgical procedures; however, they exhibit considerable morphological variability. This scoping review consolidates cadaveric morphology and morphometry to define reliable versus variable medial sulcal features that guide surgical corridors and radiologic localisation. Aim: To synthesise cadaveric morphological and morphometric data on the medial cerebral sulci and determine which sulci demonstrate consistent versus variable anatomical patterns. Materials and Methods: In the present scoping review, the comprehensive literature search identified 4,440 records in total. After applying the eligibility criteria of the original cadaveric anatomical studies that described the morphology and/or morphometry of the cingulate, paracingulate, calcarine, parietooccipital, and subparietal sulci in the human brain, a total of eight cadaveric studies were included. Data were extracted on sample characteristics, morphological classification, and quantitative morphometry of the medial cerebral sulci. Results: A total of 8 cadeveric studies met the inclusion criteria collectively examining 422 hemispheres.Across 422 hemispheres, the cingulate sulcus was consistent, whereas the paracingulate sulcus was variable in shape. The present study mapped sulcal configurations to interhemispheric approach planning. The calcarine sulcus demonstrated relatively stable morphometry, with mean anterior and posterior segment lengths of 23-35 mm. The parieto-occipital sulcus was a reliable boundary between the cuneus and precuneus, with mean lengths of approximately 40 mm. The subparietal sulcus was described less frequently, highlighting a gap in the detailed morphometric literature. Conclusion: Cadaveric evidence confirms both consistent and highly variable features of the medial cerebral sulci. The paucity of detailed morphometric descriptions for certain sulci, especially the subparietal, callosal, rostral and supra-rostral sulci, underscores the need for further targeted anatomical research.