CC BY 4.0 · Indian Journal of Neurotrauma
DOI: 10.1055/s-0044-1801740
Original Article

How to Prepare Brain Specimen for White Fiber Dissection: An Illustrative Guide

1   Department of Anatomy, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
,
2   Department of Neurosurgery, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
› Author Affiliations
Funding None.

Abstract

Background White fiber dissection is a method in acquiring in-depth neuroanatomical understanding for surgical practice. Collection of brain specimen during autopsy and preparation of the brain specimen without any disruption in anatomy are essential steps as cadaveric brain dissection is an important part of neuroanatomical teaching, and it further provides an initiative of how kind and precise the dissection must be during live surgery.

Objective The aim of the study was to explain the stepwise technique of the preparation of the brain specimen for white fiber dissection as relevant to neuroanatomical and neurosurgical teaching.

Materials and Methods The brain removal procedure is performed on the human brain during the conventional autopsy process.

Results Various consecutive and typical steps are recommended for the removal and preparation of the specimen. Photographs accompany each relevant step for better understanding of the procedure.

Conclusion In this article, we describe the technique and step-by-step guidelines to effectively remove the brain and to prepare the brain specimen for white fiber dissection. Avoiding common errors during this intricate procedure saves time and brain specimens.



Publication History

Article published online:
07 January 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 
  • References

  • 1 Türe U, Yaşargil DC, Al-Mefty O, Yaşargil MG. Topographic anatomy of the insular region. J Neurosurg 1999; 90 (04) 720-733
  • 2 Rhoton Jr AL. Cranial anatomy and surgical approaches. Neurosurgery 2020; 53: 1-7
  • 3 Wanibuchi M, Friedman AH, Fukushima T. Photo atlas of skull base dissection: techniques and operative approaches. Ann R Coll Surg Engl 2010; 92: 717-719
  • 4 Kucukyuruk B, Yagmurlu K, Tanriover N, Uzan M, Rhoton Jr AL. Microsurgical anatomy of the white matter tracts in hemispherotomy. Neurosurgery 2014; 10 (Suppl. 02) 305-324 , discussion 324
  • 5 Martino J, Vergani F, Robles SG, Duffau H. New insights into the anatomic dissection of the temporal stem with special emphasis on the inferior fronto-occipital fasciculus: implications in surgical approach to left mesiotemporal and temporoinsular structures. Neurosurgery 2010; 66 (3, suppl opperative): 4-12
  • 6 Sincoff EH, Tan Y, Abdulrauf SI. White matter fiber dissection of the optic radiations of the temporal lobe and implications for surgical approaches to the temporal horn. J Neurosurg 2004; 101 (05) 739-746
  • 7 Yaşargil MG, Krayenbühl N, Roth P, Hsu SP, Yaşargil DC. The selective amygdalohippocampectomy for intractable temporal limbic seizures. J Neurosurg 2010; 112 (01) 168-185
  • 8 Yasargil MG, Türe U, Yasargil DC. Impact of temporal lobe surgery. J Neurosurg 2004; 101 (05) 725-738
  • 9 Latini F. New insights in the limbic modulation of visual inputs: the role of the inferior longitudinal fasciculus and the Li-Am bundle. Neurosurg Rev 2015; 38 (01) 179-189 , discussion 189–190
  • 10 Latini F, Hjortberg M, Aldskogius H, Ryttlefors M. The use of a cerebral perfusion and immersion-fixation process for subsequent white matter dissection. J Neurosci Methods 2015; 253: 161-169
  • 11 Silva SM, Andrade JP. Neuroanatomy: the added value of the Klingler method. Ann Anat 2016; 208: 187-193
  • 12 Silva SM, Cunha-Cabral D, Andrade JP. Neurosurgical relevance of the dissection of the diencephalic white matter tracts using the Klingler technique. Clin Neurol Neurosurg 2017; 156: 35-40
  • 13 Flores-Justa A, Baldoncini M, Pérez Cruz JC. et al. White matter topographic anatomy applied to temporal lobe surgery. World Neurosurg 2019; 132: e670-e679
  • 14 Costa M, Braga VL, Yağmurlu K, Centeno RS, Cavalheiro S, Chaddad-Neto F. A technical guide for fiber tract dissection of the internal capsule. Turk Neurosurg 2018; 28 (06) 934-939
  • 15 de Castro I, Christoph DdeH, dos Santos DP, Landeiro JA. Internal structure of the cerebral hemispheres: an introduction of fiber dissection technique. Arq Neuropsiquiatr 2005; 63 (2A): 252-258
  • 16 Dziedzic TA, Balasa A, Jeżewski MP, Michałowski Ł, Marchel A. White matter dissection with the Klingler technique: a literature review. Brain Struct Funct 2021; 226 (01) 13-47
  • 17 Kadri PAS, de Oliveira JG, Krayenbühl N. et al. Surgical approaches to the temporal horn: an anatomic analysis of white matter tract interruption. Oper Neurosurg (Hagerstown) 2017; 13 (02) 258-270
  • 18 Peuskens D, van Loon J, Van Calenbergh F, van den Bergh R, Goffin J, Plets C. Anatomy of the anterior temporal lobe and the frontotemporal region demonstrated by fiber dissection. Neurosurgery 2004; 55 (05) 1174-1184
  • 19 Baran O, Baydin S, Gungor A. et al. Surgical approaches to the thalamus in relation to the white matter tracts of the cerebrum. World Neurosurg 2019; 128: e1048-e1086
  • 20 Capilla-Guasch P, Quilis-Quesada V, Regin-Neto M, Holanda VM, González-Darder JM, de Oliveira E. White matter relationships examined by transillumination technique using a lateral transcortical parietal approach to the atrium: three-dimensional images and surgical considerations. World Neurosurg 2019; 132: e783-e794
  • 21 Di Carlo DT, Benedetto N, Duffau H. et al. Microsurgical anatomy of the sagittal stratum. Acta Neurochir (Wien) 2019; 161 (11) 2319-2327
  • 22 Goryainov SA, Kondrashov AV, Gol'dberg MF. et al. Long association tracts of the human white matter: an analysis of 18 hemisphere dissections and in vivo HARDI-CSD tractography. Dlinnye assotsiativnye provodyashie puti belogo veshchestva golovnogo mozga cheloveka: analiz dissektsii 18 polusharii i HARDI-CSD traktografii in vivo. Vopr Neirokhir 2017; 81 (01) 13-25
  • 23 Panesar SS, Belo JTA, Yeh FC, Fernandez-Miranda JC. Structure, asymmetry, and connectivity of the human temporo-parietal aslant and vertical occipital fasciculi. Brain Struct Funct 2019; 224 (02) 907-923
  • 24 Pescatori L, Tropeano MP, Manfreda A, Delfini R, Santoro A. Three-dimensional anatomy of the white matter fibers of the temporal lobe: surgical implications. World Neurosurg 2017; 100: 144-158
  • 25 Serra C, Türe U, Krayenbühl N, Şengül G, Yaşargil DC, Yaşargil MG. Topographic classification of the thalamus surfaces related to microneurosurgery: a white matter fiber microdissection study. World Neurosurg 2017; 97: 438-452
  • 26 Vergani F, Mahmood S, Morris CM, Mitchell P, Forkel SJ. Intralobar fibres of the occipital lobe: a post mortem dissection study. Cortex 2014; 56: 145-156
  • 27 Wu Y, Sun D, Wang Y, Wang Y, Wang Y. Tracing short connections of the temporo-parieto-occipital region in the human brain using diffusion spectrum imaging and fiber dissection. Brain Res 2016; 1646: 152-159
  • 28 Klingler J, Gloor P. The connections of the amygdala and of the anterior temporal cortex in the human brain. J Comp Neurol 1960; 115: 333-369
  • 29 Rigoard P, Buffenoir K, Jaafari N. et al. The accumbofrontal fasciculus in the human brain: a microsurgical anatomical study. Neurosurgery 2011; 68 (04) 1102-1111 , discussion 1111
  • 30 Sincoff EH, Tan Y, Abdulrauf SI. White matter fiber dissection of the optic radiations of the temporal lobe and implications for surgical approaches to the temporal horn. J Neurosurg 2004; 101 (05) 739-746
  • 31 Bozkurt B, Yagmurlu K, Middlebrooks EH. et al. Fiber connections of the supplementary motor area revisited: methodology of fiber dissection, DTI, and three dimensional documentation. J Vis Exp 2017; 123: 55681
  • 32 Güngör A, Baydın ŞS, Holanda VM. et al. Microsurgical anatomy of the subthalamic nucleus: correlating fiber dissection results with 3-T magnetic resonance imaging using neuronavigation. J Neurosurg 2019; 130 (03) 716-732