Feasibility of ventricular expansion postmortem

A novel laboratory model for neurosurgical training that simulates intraventricular endoscopic surgery: Laboratory investigation

R. Shane Tubbs, Marios Loukas, Mohammadali M. Shoja, John C. Wellons, Aaron Cohen-Gadol

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Object. Cadavers are often used in the teaching of various neurosurgical procedures. One aspect of this resource that has not been previously explored is the postmortem dilation of the ventricular system, which is often collapsed, for the purpose of training neurosurgeons in the use of intraventricular endoscopy. Methods. Nine adult cadavers without a history of hydrocephalus or other known intracranial pathology were used for this study. Four specimens were obtained post embalming, and 5 specimens were fresh (time from death until the procedure < 5 hours). In all cadavers catheters were placed into the lateral ventricles; saline and then air were injected into the ventricles through the catheters. Ventriculostomy sites were filled with rubber stoppers, and in fresh specimens, formal embalming was performed with cadavers in the Trendelenburg position. Lastly, serial horizontal sectioning of the cranium was performed in all cadavers to verify ventricular dilation. Results. None of the 4 embalmed specimens were found to have ventriculomegaly following injection. However, this condition was found in 4 of the 5 fresh specimens. In the single fresh cadaver without ventriculomegaly, the cause of death had been massive intracranial subarachnoid hemorrhage, which distorted the ventricular system. This may have prevented cannulation of the ventricle and ventricular expansion in this specimen. Conclusions. The ventricular system of fresh human cadavers can be dilated postmortem. The method described herein may be useful to neurosurgical trainees or those trained neurosurgeons wishing to practice intraventricular endoscopy.

Original languageEnglish
Pages (from-to)1165-1167
Number of pages3
JournalJournal of Neurosurgery
Volume111
Issue number6
DOIs
StatePublished - Dec 2009

Fingerprint

Cadaver
Embalming
Endoscopy
Dilatation
Catheters
Head-Down Tilt
Ventriculostomy
Neurosurgical Procedures
Lateral Ventricles
Rubber
Subarachnoid Hemorrhage
Hydrocephalus
Skull
Catheterization
Cause of Death
Teaching
Air
Pathology
Injections

Keywords

  • Anatomy
  • Endoscopy
  • Hydrocephalus
  • Neurosurgery
  • Training

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Feasibility of ventricular expansion postmortem : A novel laboratory model for neurosurgical training that simulates intraventricular endoscopic surgery: Laboratory investigation. / Tubbs, R. Shane; Loukas, Marios; Shoja, Mohammadali M.; Wellons, John C.; Cohen-Gadol, Aaron.

In: Journal of Neurosurgery, Vol. 111, No. 6, 12.2009, p. 1165-1167.

Research output: Contribution to journalArticle

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abstract = "Object. Cadavers are often used in the teaching of various neurosurgical procedures. One aspect of this resource that has not been previously explored is the postmortem dilation of the ventricular system, which is often collapsed, for the purpose of training neurosurgeons in the use of intraventricular endoscopy. Methods. Nine adult cadavers without a history of hydrocephalus or other known intracranial pathology were used for this study. Four specimens were obtained post embalming, and 5 specimens were fresh (time from death until the procedure < 5 hours). In all cadavers catheters were placed into the lateral ventricles; saline and then air were injected into the ventricles through the catheters. Ventriculostomy sites were filled with rubber stoppers, and in fresh specimens, formal embalming was performed with cadavers in the Trendelenburg position. Lastly, serial horizontal sectioning of the cranium was performed in all cadavers to verify ventricular dilation. Results. None of the 4 embalmed specimens were found to have ventriculomegaly following injection. However, this condition was found in 4 of the 5 fresh specimens. In the single fresh cadaver without ventriculomegaly, the cause of death had been massive intracranial subarachnoid hemorrhage, which distorted the ventricular system. This may have prevented cannulation of the ventricle and ventricular expansion in this specimen. Conclusions. The ventricular system of fresh human cadavers can be dilated postmortem. The method described herein may be useful to neurosurgical trainees or those trained neurosurgeons wishing to practice intraventricular endoscopy.",
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N2 - Object. Cadavers are often used in the teaching of various neurosurgical procedures. One aspect of this resource that has not been previously explored is the postmortem dilation of the ventricular system, which is often collapsed, for the purpose of training neurosurgeons in the use of intraventricular endoscopy. Methods. Nine adult cadavers without a history of hydrocephalus or other known intracranial pathology were used for this study. Four specimens were obtained post embalming, and 5 specimens were fresh (time from death until the procedure < 5 hours). In all cadavers catheters were placed into the lateral ventricles; saline and then air were injected into the ventricles through the catheters. Ventriculostomy sites were filled with rubber stoppers, and in fresh specimens, formal embalming was performed with cadavers in the Trendelenburg position. Lastly, serial horizontal sectioning of the cranium was performed in all cadavers to verify ventricular dilation. Results. None of the 4 embalmed specimens were found to have ventriculomegaly following injection. However, this condition was found in 4 of the 5 fresh specimens. In the single fresh cadaver without ventriculomegaly, the cause of death had been massive intracranial subarachnoid hemorrhage, which distorted the ventricular system. This may have prevented cannulation of the ventricle and ventricular expansion in this specimen. Conclusions. The ventricular system of fresh human cadavers can be dilated postmortem. The method described herein may be useful to neurosurgical trainees or those trained neurosurgeons wishing to practice intraventricular endoscopy.

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