Fiber dissection technique: Lateral aspect of the brain

OBJECTIVE: The fiber dissection technique involves peeling away the white m atter tracts of the brain to display its three-dimensional anatomic organiz ation. Early anatomists demonstrated many tracts and fasciculi of the brain using this technique. The complexities of the preparation of the brain and the execution of fiber dissection have led to the neglect of this method, particularly since the development of the microtome and histological techni ques. Nevertheless, the fiber dissection technique is a very relevant and r eliable method for neurosurgeons to study the details of brain anatomic fea tures. METHODS: Twenty previously frozen, formalin-fixed human brains were dissect ed from the lateral surface to the medial surface, using the operating micr oscope. Each stage of the process is described. The primary dissection tool s were handmade, thin, wooden spatulas with tips of various sizes. RESULTS: We exposed and studied the myelinated fiber bundles of the brain a nd acquired a comprehensive understanding of their configurations and locat ions. CONCLUSION: The complex structures of the brain can be more clearly defined and understood when the fiber dissection technique is used. This knowledge can be incorporated into the preoperative planning process and applied to surgical strategies. Fiber dissection is time-consuming and complex, but it greatly adds to our knowledge of brain anatomic features and thus helps im prove the quality of microneurosurgery. Because other anatomic techniques f ail to provide a true understanding of the complex internal structures of t he brain, the reestablishment of fiber dissection of white matter as a stan dard study method is recommended.