White matter microdissection of the lateral aspect of the brain: 2-dimensional video demonstration

The white matter dissection technique owes its modern recognition to Josef Klingler, whose fixation protocol enabled detailed fiber bundle visualization and led to an outstanding and still relevant atlas of white matter anatomy. After a period of decline in the late twentieth century, the technique was reintroduced into neurosurgical training with the aid of the surgical microscope, emphasizing the importance of fiber dissection and its practical applications in clinical neuroanatomy. This article provides a structured, step-by-step demonstration of white matter microdissection, progressing from superficial anatomy to deeper fiber layers. Its main contribution is the supplementary video, which offers a detailed, structured demonstration of the dissection steps and white matter layers, replicating the format and clarity of hands-on dissection courses. Careful editing and post-processing were applied to optimize educational impact.

The dissection was recorded during the 7th Sulci, Gyri, Ventricles and Fiber Dissection Hands-on Course (Taipei, November 2024). Identifiable participants gave informed consent for publication.

The video illustrates a systematic lateral-to-medial dissection, beginning with sulcal and gyral identification. Grey matter is removed to expose U-fibers, followed by progressive visualization of the superior longitudinal fasciculus, insular cortex, extreme and external capsules, claustrum, basal ganglia, and anterior commissure. Each step is accompanied by commentary and technical tips to guide the dissection and preserve anatomical integrity.

By mastering the topography of white matter, neurosurgeons can enhance their understanding of pathological anatomy, allowing for precise mental rehearsal and strategic planning before surgery. This approach underscores the enduring importance of anatomical studies in improving surgical outcomes and advancing neurosurgical practice.