Uncus

Clinical significance

The part of the olfactory cortex that is on the temporal lobe covers the area of the uncus, which leads into the two significant clinical aspects: herniations and seizures

• Herniations of the brain can occur if increased intracranial pressure due to a tumor, hemorrhage, or edema pushes the uncus over the tentorial notch against the brainstem and related cranial nerves. This can compress the oculomotor nerve (CN III).

This causes problems associated with a non-functional or problematic CN III - the pupil on the ipsilateral side fails to constrict to light and absence of medial/superior movement of the orbit, resulting in a fixed, dilated pupil and an eye with a characteristic "down and out" position due to dominance of the abducens and trochlear nerves. Further pressure on the midbrain results in progressive lethargy, coma and death due to compression of the mesencephalic reticular activating system.

Brainstem damage is typically ipsilateral to the herniation, although the contralateral cerebral peduncle may be pushed against the tentorial notch, resulting in a characteristic indentation known as Kernohan's notch and ipsilateral hemiparesis, since fibers running in the cerebral peduncle decussate (cross over) in the lower medulla to control muscle groups on the opposite side of the body. The landmark indicates the amygdala.

• Seizures that originate in the uncus are known as uncinate fits which are characterized by hallucinations of taste or smell.

Function

A sparse amount of literature exists to propose a comprehensive overview of the functionality of the uncus. A study has indicated that psychotic-like experiences were associated with reduced expansion within the uncus between the ages of 14 and 19 in cannabis-using individuals.

Additional images

File:Uncus animation small.gif|Position of uncus (red) File:Gehirn, basal - beschriftet lat.svg|Basal view of a human brain File:Gray732.png|Scheme of rhinencephalon. (Uncus labeled at bottom right.)

References

References

1. Smith, Callum. (15 July 2017). "Rhinal sulcus {{!}} Radiology Reference Article {{!}} Radiopaedia.org".
2. (15 December 2014). "Uncus {{!}} Radiology Reference Article {{!}} Radiopaedia.org".
3. (2006). "Atlas of Regional Anatomy of the Brain Using MRI". Springer-Verlag.
4. (2010). "uncinate fits". Oxford University Press.
5. (2020). "Cannabis-associated psychotic-like experiences are mediated by developmental changes in the parahippocampal gyrus". Journal of the American Academy of Child and Adolescent Psychiatry.