2025 Proffered Presentations
S152: REVEALING THE INTRINSIC ANATOMY OF THE BRAINSTEM: ADVANCING VISUALIZATION THROUGH FIBER DISSECTION AND PHOTOREALISTIC PHOTOGRAMMETRY-BASED THREE-DIMENSIONAL MODELING
Rahmanov Serdar1; Hüseyin Ikbal Akdemir2; Baris Kaval3; Abuzer Güngör4; Muhammet Enes Gurses5; Yücel Dogruel6; Ugur Türe7; 1Cleveland Clinic Florida; 2Marmara University; 3Bakirköy Prof. Dr. Mazhar Osman Training and Research Hospital; 4Istinye University; 5University of Southern California; 6Tepecik Training and Research Hospital; 7Yeditepe University
Objective: This study aims to investigate the intrinsic white matter anatomy of the brainstem through microscopic fiber dissection and three-dimensional (3D) modeling, with a focus on improving neurosurgical planning and clinical applications. Given the critical role of the brainstem in regulating bodily functions and facilitating communication between the brain and spinal cord, a comprehensive understanding of its intricate anatomy is essential to mitigate the risks associated with surgical interventions.
Materials and Methods: Twenty-five cadaveric brainstem specimens were prepared according to the method described by Klingler. The fiber Dissection was performed using a Carl Zeiss f170 microscope. At each stage of dissection, 2D and 3D images were acquired using DSLR cameras. The images were processed using a photogrammetric technique and 3D reconstruction was performed using Agisoft Metashape software (Agisoft LLC, St. Petersburg, Russia). The resulting 3D models were refined using Blender software (Blender Foundation, Amsterdam, Netherlands) and made available on the Sketchfab platform (Sketchfab Inc., New York, USA).
Results: Microscopic dissection revealed a comprehensive and detailed internal anatomy of the brainstem. Key structures were identified, including the ventral pons, cranial nerve roots with their trajectories in the brainstem, pyramidal tracts and their decussations, medial and lateral lemniscus fibers, cerebellar peduncles, and nuclei. The study culminated in the creation of a high-resolution, 360-degree photorealistic 3D model of the brainstem, providing enhanced visualization and invaluable insight for both neurosurgical planning and neuroscience research.
Conclusions: This study highlights the substantial contributions of fiber dissection in elucidating the intrinsic white matter anatomy of the brainstem. The detailed examination of white matter tracts, neural connections, and cranial nerves provides critical insights for neurosurgical planning and clinical applications. In addition, the use of 3D reconstruction models enhances visualization and understanding of the complex organization of the brainstem, benefiting neurosurgeons at all levels of experience.
