English

Abstract

After proper preparations of body, removal of brain, brain stem with spinal cord were done. Total thirty (30) cadavers were dissected in a span of three (3) years in Katihar Medical College, Katihar, Bihar, India with good results. The removal of vault of skull, squamous part of occipital bone, posterior arch of atlas, followed by bilateral laminectomy of vertebrae, helps in viewing of brain, brain stem and spinal cord along with spinal nerve roots and cauda equina. This approach helps in total removal of brain, brain stem and spinal cord with its covering with large venous sinuses remaining intact however small venous sinuses are sacrificed in this process. The specimen thus obtained can be used for autopsy or anatomical study. INTRODUCTION: The approach adopted mostly for removal of brain entails beginning with removal of scalp enmasse and then a saw cut around the bare skull bones. The procedures results in inevitable damage to the brain stem with some of the nerve roots being severed and clear visibility of the posterior fossa is not possible - a limitation of the conventional procedure. On above view an alternative approach for removal of brain with spinal cord has been contemplated and is being practiced in department 0f anatomy, with good results. This approach will be helpful for the orthopedic and neurosurgery students. For forensic study blood haematoma is easily seen and spinal cord injury can be assessed. MATERIALS AND METHOD: Cadavers after proper embalming were selected for this study, the work done in Katihar Medical College, Katihar, Bihar. Thirty (30) cadavers were dissected in span of three (3) years. Instrument used for this dissection were toothed & untoothed forceps, scissors, scalpel, chisel, hand saw, hammer, periosteum elevator, long bladed knife, retractor, bone nibbler, bone cutter and electric saw. In this study, the approach followed is a combination of the classical approaches for removal of brain and spinal cord (brash J.C 1958) with an addition involving the removal of the remains of the squamous part of the occipital bone left over after the removal of skull cap by a circumferential cut and posterior laminectomy of all vertebrae (canale S.T -1998). On the dissection table, before starting the dissection, the cadavers selected were laid in supine position. The head was cleanly shaved, with skin pencil a circular mark was drawn (anteriorly 2 cm above the margin of the orbit, laterally above the auricle and posteriorly 1 cm above the occiput).By a sharp long blade knife along the marked line the scalp enmasse is freed from the skull cap. The avulsed scalp is made to hang by pedicle at the root of the nose. Next a circular saw cut is given across the skull, keeping the cutting edge of the saw on the top of the skin edge surrounding the lower part of the head, thus a little more than vault of skull is removed leaving the endosteal layer of dura and venous sinuses with the brain.