Efficiency in Brain Removal Techniques: A Potentially Novel Approach

Abstract

Dissection of the human brain is an important part of health professional education in the neuroscience curriculum. Therefore, it is critical that adequate protocols are utilized to preserve structures when removing brains from cadavers. Previous studies have looked at approaches to extracting the brain and associated structures from the cranial cavity which would best preserve these delicate structures. However, these methods require both extensive dissection experience and more time than suitable for routine use. The aim of this study was to determine the technique for brain removal that minimized the time required for the procedure while preserving key structures for future educational purposes.The time and ease for three aspects of brain extraction were assessed: removal of the calvaria, subsequent removal of the brain, and transection of the brainstem. Six dissectors (two faculty, four senior graduate students) with prior experience performed the removals. Each tested three calvaria‐removal approaches – circumferential only, circumferential plus a median cut, and circumferential plus a coronal cut. They also tested three approaches to brainstem transection—superiorly through the foramen magnum, inferiorly below C1 vertebra, or inferiorly after removal of an occipital wedge. The time for each procedure was recorded, and its ease was evaluated on a 5 point scale (1 easiest and 5 hardest). The combination of calvaria and brainstem approaches and the order of completion were randomized across dissectors and the 3 brains extracted by each. At the completion of brain removal, all brains were evaluated by two neuroscience course directors for utility in educational contexts. The evaluators rated structures on a list compiled from the laboratory handouts in the medical neuroscience course.Preliminary examination of the data suggests that removal of the calvaria using only the circumferential cut or using an additional coronal cut took about the same length of time, whereas performing circumferential and median cuts took somewhat longer. However, the ease of removal was greater when either the additional median or coronal cut was employed. Transecting the brainstem took less than a minute if performed through the foramen magnum or below C1, but it took substantially longer if the occipital wedge cut was executed. The ease of transection was greatest when performed below C1, and least when the occipital wedge was removed. There was no clear difference in overall quality of the brains removed by the various techniques.While there may be advantages to one or the other of the techniques for preservation of specific structures, it appears that all approaches tested were equivalent in yielding brains that could be used for educational purposes.