Çırak Musa, Yağmurlu Kaan, Soldozy Sauson, Norat Pedro, Shaffrey Mark E, Kalani Mohammad Yashar S
Department of Neurological Surgery, University of Virginia, Charlottesville, VA 22903, USA.
Department of Neuroscience, University of Virginia, Charlottesville, VA 22903, USA.
Brain Sci. 2020 Dec 31;11(1):32. doi: 10.3390/brainsci11010032.
Neuroanatomy laboratory training is crucial for the education of neurosurgery residents and medical students. Since the brain is a complex and three-dimensional structure, it is challenging to understand the anatomical relationship of the cortex, internal structures, arteries, and veins without appropriate adjuncts. Several injection agents-including the inks/dyes, latex, polyester, acrylic resins, phenol, polyethylene glycol, and phenoxyethanol-have been explored. Colored silicon injection protocols for the head and neck vessels' perfusion have greatly aided the study of neuroanatomy and surgical planning. This report presents a colored silicone injection method in detail, and also highlights the technical shortcomings of the standard techniques and workarounds for common challenges during 35 human cadaveric head injections. The human cadaveric head preparation and the coloring of the head vessels are divided into decapitation, tissue fixation with 10% formalin, the placement of the Silastic tubing into the parent vessels, the cleaning of the vessels from clots, and the injection of the colored silicone into the vessels. We describe the technical details of the preparation, injection, and preservation of cadaveric heads, and outline common challenges during colored silicone injection, which include the dislocation of the Silastic tubing during the injection, the injection of the wrong or inappropriate colored silicone into the vessel, intracranial vessel perforation, the incomplete silicone casting of the vessel, and silicone leakage from small vessels in the neck. Solutions to these common challenges are provided. Ethyl alcohol fixed, colored human heads provided the long-term preservation of tissue, and improve the sample consistency and preservation for the teaching of neuroanatomy and surgical technique.
神经解剖学实验室培训对于神经外科住院医师和医学生的教育至关重要。由于大脑是一个复杂的三维结构，在没有适当辅助手段的情况下，理解皮质、内部结构、动脉和静脉的解剖关系具有挑战性。人们已经探索了几种注射剂，包括墨水/染料、乳胶、聚酯、丙烯酸树脂、苯酚、聚乙二醇和苯氧乙醇。用于头颈部血管灌注的彩色硅注射方案极大地有助于神经解剖学研究和手术规划。本报告详细介绍了一种彩色硅注射方法，并突出了标准技术的技术缺陷以及在35例人体尸体头部注射过程中应对常见挑战的解决方法。人体尸体头部的制备和头部血管的染色分为断头、用10%福尔马林固定组织、将硅橡胶管放置到母血管中、清除血管内的血凝块以及将彩色硅注射到血管中。我们描述了尸体头部制备、注射和保存的技术细节，并概述了彩色硅注射过程中的常见挑战，包括注射过程中硅橡胶管的移位、将错误或不合适的彩色硅注射到血管中、颅内血管穿孔、血管的硅铸型不完全以及颈部小血管的硅泄漏。针对这些常见挑战提供了解决方案。乙醇固定的彩色人体头部可长期保存组织，并提高神经解剖学教学和手术技术的样本一致性和保存效果。
