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现代神经外科尸体研究实践的历史根源:解剖、保存和血管注射技术。

Historical Roots of Modern Neurosurgical Cadaveric Research Practices: Dissection, Preservation, and Vascular Injection Techniques.

作者信息

On Thomas J, Xu Yuan, Tayebi Meybodi Ali, Alcantar-Garibay Oscar, Castillo Andrea L, Özak Ahmet, Abramov Irakliy, Forcht Dagi T, Preul Mark C

机构信息

The Loyal and Edith Davis Neurosurgical Research Laboratory, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.

Department of Neurosurgery, Mayo Clinic Alix School of Medicine, Rochester, Minnesota, USA.

出版信息

World Neurosurg. 2024 Dec;192:43-55. doi: 10.1016/j.wneu.2024.08.120. Epub 2024 Aug 30.

DOI:10.1016/j.wneu.2024.08.120
PMID:39216723
Abstract

Because of the complexity of the brain and its structures, anatomical knowledge is fundamental in neurosurgery. Anatomical dissection, body preservation, and vascular injection remain essential for training, teaching, and refining surgical techniques. This article explores the historical development of these practices and provides the contextual background of modern neurosurgical cadaveric brain models. Body preservation has ancient beginnings, evident in the Chinchorro mummifications and Egyptian embalming. However, brain preservation techniques for education were scarce until the beginning of the Renaissance in Europe. At the University of Bologna in the 13th century, occasional dissections were performed only in winter because of the lack of preservation techniques. Pope Sixtus IV's 1482 papal bull (official decree) formalized and expanded the use of dissection in medical education, leading to an explosion in anatomical studies. This surge brought advances in body preservation, such as soaking bodies in vinegar and distilled liquors. In subsequent centuries, Andreas Vesalius and Charles Bell advanced brain anatomical techniques and knowledge, combining novel illustrations and instruction. To better understand brain vasculature, Richard Lower developed vascular injection techniques using india ink and spirits of wine, leading to the 1664 description of the circle of Willis by Thomas Willis. In 1868, August Hofmann synthesized formaldehyde, markedly improving tissue preservation. Later, William Kruse introduced latex in 1939, and Sidney Sobin introduced silicone in 1965 for vascular studies. These advancements laid the foundation for modern neurosurgical cadaveric studies, many remaining relevant today.

摘要

由于大脑及其结构的复杂性,解剖学知识在神经外科中至关重要。解剖 dissection、尸体保存和血管注射对于培训、教学以及完善手术技术仍然必不可少。本文探讨了这些实践的历史发展,并提供了现代神经外科尸体脑模型的背景情况。尸体保存有着古老的起源,在钦乔罗木乃伊制作和埃及防腐术中可见一斑。然而,直到欧洲文艺复兴初期,用于教育的脑保存技术都很匮乏。13世纪在博洛尼亚大学,由于缺乏保存技术,偶尔的解剖仅在冬季进行。教皇西克斯图斯四世1482年的教皇诏书(官方法令)使解剖在医学教育中的使用正式化并得以扩展,导致解剖学研究激增。这一热潮带来了尸体保存方面的进步,比如将尸体浸泡在醋和蒸馏酒中。在随后的几个世纪里,安德烈亚斯·维萨里和查尔斯·贝尔推进了脑解剖技术和知识,将新颖的插图与教学相结合。为了更好地理解脑血管系统,理查德·洛厄使用印度墨水和葡萄酒 spirits 开发了血管注射技术,托马斯·威利斯在1664年对 Willis 环进行了描述。1868年,奥古斯特·霍夫曼合成了甲醛,显著改善了组织保存。后来,威廉·克鲁斯在1939年引入了乳胶,西德尼·索宾在1965年引入了硅酮用于血管研究。这些进步为现代神经外科尸体研究奠定了基础,其中许多至今仍然相关。

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