• Christos Koutsarnakis, Faidon Liakos, Aristotelis V Kalyvas, Damianos E Sakas, and George Stranjalis.
• Department of Neurosurgery, University of Athens, Evaggelismos Hospital, Athens, Greece; Microneurosurgery Laboratory, Evaggelismos Hospital, Athens, Greece. Electronic address: ckouts@hotmail.co.uk.
• World Neurosurg. 2015 Aug 1; 84 (2): 483-93.

ObjectiveWhite matter fiber dissection is an important method in acquiring a thorough neuroanatomic knowledge for surgical practice. Previous studies have definitely improved our understanding of intrinsic brain anatomy and emphasized on the significance of this technique in modern neurosurgery. However, current literature lacks a complete and concentrated laboratory guide about the entire dissection procedure. Hence, our primary objective is to introduce a detailed laboratory manual for cerebral white matter dissection by highlighting consecutive dissection steps, and to stress important technical comments facilitating this complex procedure.MethodsTwenty adult, formalin-fixed cerebral hemispheres were included in the study. Ten specimens were dissected in the lateromedial and 10 in the mediolateral direction, respectively, using the fiber dissection technique and the microscope.ResultsEleven and 8 consecutive and distinctive dissection steps are recommended for the lateromedial and mediolateral dissection procedures, respectively. Photographs highlighting various anatomic landmarks accompany every step. Technical recommendations, facilitating the dissection process, are also indicated.ConclusionsThe fiber dissection technique, although complex and time consuming, offers a three-dimensional knowledge of intrinsic brain anatomy and architecture, thus improving both the quality of microneurosurgery and the patient's standard of care. The present anatomic study provides a thorough dissection manual to those who study brain anatomy using this technique.Copyright © 2015 Elsevier Inc. All rights reserved.

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