Description
Clinical History
A 37-year-old patient presented to hospital after falling and striking his head, with subsequent symptoms of headache, vomiting and disorientation. CT scan showed dilatation of the lateral ventricles associated with a large mass projecting into the third ventricle posteriorly. One week later a shunt was performed for hydrocephalus. An angiogram revealed a partially thrombosed aneurysm, measuring 1 x 1 cm, arising from the basilar artery. At 3-months post-op the shunt was revised due to obstruction, with repeat cerebral angiogram revealing interval enlargement of the aneurysm. Attempted ligation of the aneurysm was unsuccessful. The patient remained unconscious despite several attempts to revise the shunt and he died.
Pathology
This brain has been sliced in the mid-sagittal plane. It comprises a whole hemi-section of the brain about 1cm thick. On the medial surface a large darkly-colored ovoid berry aneurysm measuring 5 x 2 cm in diameter, arising from the basilar artery is clearly visible. It has eroded up into the midbrain, compressing the third ventricle from below, and inferiorly into the substance of the pons. The wall of the aneurysm appears intact although blood clot is seen in the third ventricle and appears to be leaking through the lateral wall of that ventricle. The aneurysm is filled with a laminated thrombus. A small area of mucoid degeneration measuring 0.4 cm in diameter is seen posterior to the aneurysm within the pons.
Examination of the lateral aspect of the sagittal section shows dilatation of the lateral ventricle, blood staining of the ventricular wall and patchy hemorrhagic infarction of the caudate nucleus. There was some discoloration of the meninges overlying the tip of the left temporal lobe and the cerebellum (not included in 3D print), consistent with sub-arachnoid hemorrhage.
Further Information
Prevalence of aneurysms is approximately 3.2% in the population, while rupture is much less common, occurring only 7.9 per 100,000 person-years. A minority of intracranial aneurysms arise from the posterior circulation, and are mostly situated at junctional points about the basilar, vertebral and cerebellar arteries. Symptoms are either secondary to subarachnoid hemorrhage or a mass effect with associated compression of the adjacent brain parenchyma and cranial nerves. Rupture causes complications due to bleeding and raised intracranial pressure. Hydrocephalus, re-bleed and vasospasm may also occur. Management is via surgical means; in recent years, novel therapies include endovascular intervention with coils and subsequent monitoring.
Advantages
- Anatomically accurate and identical to real specimen
- No ethical issues - not real human body parts
- Reasonably priced
- Available within a short lead time
- Reproducible, several identical prints can be used as a classroom set
- Can be produced in different sizes to cater for the needs of the teacher
Human Cadavers
- Access to cadavers can be problematic. Many countries cannot access cadavers for cultural and religious reasons
- Cadavers cost a lot money
- High cost for establishing your own plastination suite
- Wet specimens cannot be used in uncertified labs
- Dissection of cadavers is a lot of staff time and that is a cost
- Storage of cadaver material needs special refrigeration etc. which has coast
- If you want another specimen you have to start all over again
Plastinates
- Costs
- Ethical issues
- Timeframe for plastination process
- Many countries do not allow their importation
- One of a kind
Superior 3D print results compared with conventional methods
- Vibrant color offering with 10 million colors
- UV-curable inkjet printing
- High quality 3D printing that can create products that are delicate, extremely precise and incredibly realistic
Clear Support Material
- To avoid breakage of fragile, thin, and delicate arteries, veins or vessels, a clear support material is printed on such spots. This makes the models robust and can be handled by students easily.
