Supratentorial vs. Infratentorial — What's the Difference?

Supratentorial regions are located above the tentorium cerebelli, a membrane separating the cerebrum from the cerebellum, and primarily involve the cerebral hemispheres. These areas are critical for cognitive functions such as reasoning, memory, and voluntary movements. On the other hand, infratentorial regions are situated below this membrane, encompassing the cerebellum and brainstem, which are essential for maintaining balance, coordinating movements, and controlling autonomic functions.

Supratentorial lesions, such as tumors or strokes, typically manifest with symptoms like cognitive impairment or seizures, reflecting the cerebral hemispheres' role in higher cognitive functions. Whereas, infratentorial problems can lead to issues like balance disorders, ataxia, and impaired autonomic system functions due to the involvement of the cerebellum and brainstem.

Supratentorial surgeries are often more complex due to the critical and diverse functions of the cerebral hemispheres and the risk of affecting cognitive or motor skills. In contrast, infratentorial surgeries, while equally delicate, concern areas that primarily manage reflexive or automatic bodily functions.

In the context of imaging and diagnostics, supratentorial areas are generally more accessible for techniques like MRI or CT scans, providing clear images of cerebral structures. Meanwhile, infratentorial regions might require more specialized imaging approaches to navigate around bone structures that can obstruct clear views of the brainstem and cerebellum.

Research in supratentorial disorders often focuses on neurodegenerative diseases, psychiatric conditions, and cognitive disorders, showcasing the complex functionalities of the cerebral cortex. In contrast, infratentorial research is heavily geared towards movement disorders, stroke recovery related to the brainstem and cerebellum, and mechanisms of motor control and coordination.