Description
Clinical History
A 22-year-old male presented with a 2-week history of generalized malaise, weight loss and bruised skin without any trauma. He recently developed 5 days of productive cough and fevers. He was admitted to hospital for further investigations but had a sudden loss of consciousness and died a few minutes after admission to hospital.
Pathology
The specimen is a horizontal slice of brain displaying the superior cut surface. In the right frontal and parietal regions are two large intraparenchymal hemorrhages each 5 cm in maximum diameter. Several smaller hemorrhages are present in the white matter of both hemispheres. This is an example of multiple intraparenchymal cerebral hemorrhages in a patient with acute myeloid leukemia (AML).
Further Information
Intraparenchymal brain hemorrhages are a result of small, ruptured vessels within the brain causing hemorrhage. They are usually associated with sudden onset neurological symptoms. The most common causes for spontaneous (no-traumatic) intraparenchymal hemorrhages are hypertension and cerebral amyloid angiopathy with a peak incidence in the 6th decade of life.
AML is a cancer of hematopoietic progenitors causing bone marrow failure, due to immature blast cell accumulation in the marrow. The immature blasts affect the production of other bone marrow-derived cells leading to bone marrow failure causing anemia (decreased erythrocytes), thrombocytopenia (decreased platelet production and a hemorrhage tendency) and neutropenia (decreased neutrophil production). These in turn lead to a wide spectrum of disease complications, which have to be anticipated and managed. Infection is the leading cause of death in AML as a result of neutropenia. Intracranial hemorrhage is the second most common cause of death in AML, due to low or dysfunctional platelets caused by the thrombocytopenia. A severe form of hemorrhage is termed disseminated intravascular coagulation (DIC) is common in AML. DIC is characterized by small blood clots developing throughout the bloodstream, blocking capillaries. The increased clotting depletes the platelets and clotting factors needed to control bleeding, causing excessive bleeding.
Symptoms depend on the location and severity of the bleed. Interventions include surgical evacuation of the hematoma, reversal of the coagulopathy, treatment of any seizures, and regulation of the intracranial pressure. Interventions are dependent on the severity of the bleed and clinical context. The 30-day mortality for intracerebral hemorrhage ranges from 35-50% with most deaths occurring in the first 48 hours.
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.
