In Japan, the legal bases for cadaver dissection performed by medical students are the "Postmortem Examination and Corpse Preservation Act" enacted in 1949, and "Act on Body Donation for Medical and Dental Education" promulgated in 1983. At present, cadavers for anatomical dissection are supplied totally by willing body donation, but several decades ago, the bodies used for dissection practice were mostly those of persons who had died from weakness along the road. In those days, the supply of cadavers for anatomical dissection was remarkably insufficient. Therefore, when the Act on Body Donation was enacted, it aimed to increase persons who would donate their remains mainly for the sake of medical education. Recently, the demand to use donated cadavers for surgical anatomy research and/or operation training is rising, and a few research papers have been published already. However, the exceptional use of donated cadavers may need to obtain the consent of each donor and/or its family, and to confirm legitimacy as well, because body donation in Japan has developed on a mutual trust between the medical community and the people in Japan.

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Cadaver dissection is used for the teaching of basic anatomy and for surgical simulations. We describe the processes from specimen preparation for cranial step by step dissection to 3D stereoscopic documentation, and discuss the efficacy and limitations of this educational method.

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To learn the neuroanatomy is essential for the neurosurgeons. It is important to study neuroanatomy as presented in previous textbooks, and in the literature. However, it is not enough for a three-dimensional understanding. There are papers in the literature and seminars with stereoscopic views for spatial recognition, but even these do not clarify the issues for various reasons. The authors created a three-dimensional model on the basis of the data from cadaver dissection on a personal computer using Maya^[○!R] software. Three cadaver brains were used and dissected using a fiber dissection technique established by Klingler. A three-dimensional model was constructed using the photos of the dissected brain viewed from each 15 degrees. In our method, the model with colored anatomical structures was observed from any angle, any magnification, and anytime you want. We hope our model becomes utilized as a tool for studying neuroanatomy and surgical simulation.

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White matter dissection (WMD) is a gross anatomical technique that had been used as the only technique for the study of the human brain about 350 years ago. At the beginning of the 20th century, WMD was overwhelmed by the microtome section technique and it declined rapidly. Recently, however, WMD resumed its position as a very effective practice to understand the three-dimensional structure of the human brain. This re-evaluation of WMD occurred in accord with advances of the medical electro-technology to visualize the human brain in both its structures and functions. Today, the speaker will present at first the materials, methods and techniques of WMD, then show some representative nerve fasciculi and subcortical landscapes explored by WMD.

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Cadaver dissection is essential for understanding the surgical anatomy and acquisition of the surgical techniques necessary for modern skull base surgery. However, neurosurgeons have strictly limited opportunities to train with cadaver dissection in Japan. We have developed a new skull base model with dura mater made from silicone and retractable with the surgical spatula. This model also incorporates reconstructions of the interdural structures of the cavernous sinus (CS) with the double layers (meningeal layer and inner reticular layer) of its lateral wall. Using this model, we simulated the interdural approach to the CS and anterior petrosal approach. After the epidural approach to the middle fossa base, the periosteal layer was incised at the lateral end of the CS, and then peeling of the meningeal layer was performed via the epidural space, exactly as performed in actual surgery. Kawase's triangle was drilled away with retraction of the artificial temporal dura. This new skull model enables simulation of the methods of skull base surgery via the epidural space.

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A case that presented with radiculopathy due to pneumatic compression is reported. A 58-year-old woman suffered from pain of the right lower leg. Neurological examination revealed pain of the right S_1 root lesion and a reduced achilles tendon reflex. There is no gas on X-ray film. We could comfirm a low intensity mass both on T1- and T2-weighted images, and a pneumatic mass at the right S_1 root nerve on CT myelogram. After the operation, the patients symptoms had completely disappeared.

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We report a case of ruptured distal anterior cerebral artery aneurysm with acute subdural hematoma (ASDH) located mainly at the cerebral convexity. A 67-year-old female was admitted in a coma. A CT scan taken before admission showed massive ASDH on the right convexity. Following emergency trepanation, emergency surgery was performed. After evacuation of ASDH, critical rebleeding from the intracranial space occurred. Postoperative 3D-CT angiography showed left distal anterior cerebral artery (ACA) aneurysm projecting to the upper right. We performed neck clipping of the aneurysm. Cases of ruptured distal ACA aneurysm with ASDH are not so rare, but a pattern of limited interhemispheric ASDH with massive convexity ASDH is rare. This finding tends to cause pitfalls and ruptured distal ACA aneurysm should be taken into consideration and preoperative cerebrovascular evaluations such as 3D-CTA should be performed wherever possible.

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