TUMORS OF THE OCCIPITAL LOBE*

D W I G H T PARKINSON, M.D.,t WINCHELL McK. CRAIG,

M.D., AND JAMES W. KERNOHAN, M.D.
Section on Neurologic Surgery and Section on Pathologic Anatomy, Mayo
Clinic, Rochester, Minnesota
(Received for publication May 8, 1953)

EW cases of tumors of the occipital lobe were recorded before the

F early part of the present century, ~,5,s,9,'n,12,1~,22,26,27,29,~~ and no large
series of cases of tumors confined exclusively to this lobe was report-
ed before that of tIorrax and P u t n a m in 193~. 24
ANATOMY
Though often titled, divided and subdivided, '6,2~ the occipital lobe is
still without definite boundaries. In man this lobe is roughly pyramidal in
shape having three dural surfaces: a lateral convex surface opposes the dura
of the skull, a medial fiat surface opposes the falx and an inferior sloping
surface opposes the tentorium. Posteriorly, the three surfaces meet in a
curved "point" corresponding to the cavity formed by the junction of the
falx, tentorium and dura of the skull. It is generally agreed that the medial
surface is bounded anteriorly by the parieto-occipital fissure. Books on
anatomy differ as to the anterior limits of the other two surfaces. The lateral
surface is bounded by an imaginary line drawn from the parieto-occipital
fissure to the preoccipital notch, an indefinite landmark indicated by
Ranson 31 as a fifth of the distance from the occipital to the temporal pole
and by Gray 21 as a third of this distance.
The inferior surface is variously bounded. Gray used a perpendicular
line from the prcoccipital notch to the parieto-occipital fissure. Ranson de-
picted a perpendicular line from the tip of the calcarine fissure to the col-
lateral fissure and from there on back, presumably to the level of the pre-
occipital notch.
Inasmuch as the calcarine fissure extends beyond its junction with the
parieto-occipital fissure to a point just beneath the splenium and as the
visual cortex has been definitely identified to this point, for the purpose of
our study, Gray's arbitrary boundary line is slanted forward to extend from
the preoccipital notch to the point where t h e calcarine fissure terminates
beneath the splenium (Fig. 1).
In order to determine what proportion of the entire brain is constituted
by the occipital lobe, a normal brain of an adult male body obtained at
necropsy was fixed in formalin and sectioned. The cuts were made perpen-
* Abridgment of thesis submitted by Dr. Parkinson to the Faculty of the Graduate School of the
University of Minnesota in partial fulfillment of the requirements for the degree of Master of Science in
Neurosurgery.
t Fellow in Neurosurgery, Mayo Foundation, Rochester, Minnesota.
555
 556 D. PARKINSON, W. McK. CRAIG, AND J. W. KERNOHAN
dicular to the cortical surface along the three boundaries as designated:
Laterally, a line connecting the parieto-occipital fissure with the preoccip-
ital notch which was taken as a point a third of the distance from the

Fro. 1. Boundaries of the occipital lobe are indicated on the medial (falx) surface and on the inferior
(tentorial) surface. The line for the medial surface extends straight from the dorsal edge of tile parieto-
occipital fissure to the anterior extremity of the calcarine fissure beneath the splenium. If the classic
boundary formed by the parieto-occipital fissure and calcarine fissure were used on the medial surface,
the striate cortex lying above the calcarine fissure along the anterior third would be excluded. The line
for the inferior surface is seen slanting forward from the preoecipital notch to the anterior extremity of
the calcarine fissure.

FIG. o. The boundary on the lateral

(skull) surface connects the dorsal end
of the parieto-occipital fissure with the
preoccipital notch, which is taken as a
point a third of the distance from the oc-
cipital tip to the temporal tip. (This point
is slightly too far forward in the drawing.)
FIG. 8. Lateral view of normal brain demonstrating sec-
tion connecting parieto-occipital fissure with preoccipital
notch. Owing to obliquity, the point taken as the preoccipital
notch appears less than a third of the distance to the temporal
tip.

occipital to the temporal pole (Figs. ~ and 3); inferiorly, a line connecting
the preoccipital notch with the anterior end of the calcarine fissure beneath
the splenium (Fig. 1); and medially, a line connecting this point with the
parieto-occipital fissure at its posterior boundary (Figs. 1 and 4).