Advanced fluorescence techniques in white matter fiber visualization for neurosurgical training.

Background: Neurosurgical training requires a deep understanding of brain anatomy, especially white matter fiber pathways, to enhance surgical precision. Traditional dissection techniques, such as Klingler's white matter dissection, are essential, but newer methods can provide additional clarity. This study explores the application of a fluorescent-assisted technique to improve the visualization and understanding of white matter fibers during neurosurgical training.

Methods: Twelve human brains were dissected following Klingler's protocol, with a focus white matter fiber pathway. Fluorescent alcoholic and oily solutions were applied to highlight the fibers. Ultraviolet (UV) blacklight and yellow monochromatic filters were used to enhance visualization. Dissections were documented through photography, and the effectiveness of the fluorescent techniques was analyzed.

Results: The application of UV light and fluorescent solutions enhanced the visualization of fiber pathways, particularly in regions with irregular fibers, such as the sagittal stratum. The alcoholic solution flowed along the anatomical paths of the fibers, aiding in their differentiation. The oily solution proved effective in specific areas, such as the internal capsule. The use of fluorescent techniques allowed for improved identification and anatomical detailing of major white matter tracts.

Conclusion: The fluorescent-assisted dissection technique significantly enhances the visualization of white matter fibers, offering a valuable tool for neurosurgical training. This method deepens anatomical understanding, provides a three-dimensional perspective of brain structures, and can improve surgical outcomes. The study suggests potential applications in other fields, such as glioma simulation and bypass patency testing.