To the Editor:
We read with great interest the article by Moon et al.1 We agree with them that “no other practice in medicine has contributed more to the understanding of neuroanatomy and the neurosciences as dissection of the human cadaver.” Furthermore, to the authors' comment on its role in the development of modern neurosurgery,1 we would like to comment on the, more or less, unknown role of the neuroanatomic dissection in modern stereotactic and functional neurosurgery and consequently in neuromodulation.
From our experience, neuroanatomic dissection can be used for studying stereotactic anatomy of specific brain areas through coronal, axial, and sagittal sections as in magnetic resonance imaging. Basal ganglia and other brain nuclei can be precisely identified. Stereotactic coordinates of deep brain stimulation (DBS) targets such as the subthalamic nucleus and nucleus accumbens can be determined.2 Stereotactic atlases of the human brain, whose importance in stereotactic surgery is well established, are also based on this method.
Moreover, cadaveric dissection can be used for step-by-step practicing of stereotactic neurosurgical procedures, such as DBS (its extracerebral part), by neurosurgical trainees and young neurosurgeons. Human cadaver models are especially beneficial because they are the closest to live surgery with the greatest disadvantage of lacking hemodynamic factors.3
With one or another way, neuroanatomic dissection can be a quite useful educational tool for stereotactic neurosurgery and can significantly help in the scientific progress of this neurosurgical field. Finally, we agree with Moon et al that “the traditional cadaver based training model will undoubtedly continue to be used alongside more innovative teaching methods that continue to be developed.”1
1. Moon K, Filis AK, Cohen AR. The birth and evolution of neuroscience through cadaveric dissection. Neurosurgery. 2010;67(3):799-810.
2. Mavridis I, Anagnostopoulou S. The human nucleus accumbens as a target for deep brain stimulation: Anatomical study of electrode's target point and stereotactic coordinates. Minim Invasive Neurosurg. 2009;52(5-6):212-215.
3. Olabe Jo, Olabe Ja, Sancho V. Human cadaver brain infusion model for neurosurgical training. Surg Neurol. 2009;72(6):700-702.