Klingler’s method of brain dissection: review of the technique including its usefulness in practical neuroanatomy teaching, neurosurgery and neuroimaging

Abstract

Klingler's technique was discovered in the 1930s. It is a modified method of brain fixation and dissection, based on freezing and thawing of the brain tissue, subsequent peeling away of white matter fibres and the gradual exposure of white matter tracts. The added value of this technique is that it is carried out in a stratigraphic manner. This fact makes it an invaluable tool for an in-depth understanding of the complex anatomical organisation of the cerebral hemispheres. The purpose of this paper is to provide a review of Klingler's method while taking into account the original description of the technique and its value for medical training. The historical background, the concise outline of white matter organisation, as well as our own experience in using this procedure for research and teaching activities were also included. The fibre dissection technique may still be considered an excellent complementary research tool for neuroanatomical studies. Numerous detailed observations about the white matter topography and spatial organisation have been recently made by applying this method. Using this technique may also improve understanding of the three-dimensional intrinsic structure of the brain, which is particularly important both in under-and postgraduate training in the field of neuroanatomy. (Folia Morphol 2019; 78, 3: 455-466)

Anatomy and white matter connections of the fusiform gyrus

“…Postmortem dissections were performed using a modified Klingler technique 19 . While there have been documented modifications to this technique 19 , 20 , it was first described by Ludwig and Klingler et al in 1956 21 . Initial requirement was to freeze the brains to at least − 10°C 21 .…”

“…The purpose of the post-mortem dissections was to demonstrate the location of major tracts connecting to the lateral occipital lobe. Postmortem dissections were performed using a modified Klingler technique 19 . While there have been documented modifications to this technique 19,20 , it was first described by Ludwig and Klingler et al in 1956 21 .…”

“…An example of brains frozen to temperatures up to − 80 °C is demonstrated by David et al 20 . The most comprehensive analysis of this technique is described by Wysiadecki et al 19 . There is no documented advantage to freezing temperatures beyond this point.…”

Anatomical variations of the dentate gyrus in normal adult brain

“…The gyral organization in normal human brain may vary between individuals. Thus, an understanding of the anatomical variations in the human cortex may be important for neuroanatomy teaching, diagnostic neuroimaging and for neurosurgical procedures [10,12,13,16,18,27,28]. Anatomy of the hippocampal region is thought to be very complex and difficult to understand for non-specialized neurosurgeons or neurologists [6].…”

Extreme capsule is a bottleneck for ventral pathway

“…After removing half of the cortex above the insula, the EmC appears, consisting of association fibers connecting the insula and the operculum. Upon gentle removal of the insular cortex, from internal to external, external capsule, claustrum and EmC could be seen respectively, as well as putamen ( Wysiadecki et al, 2019 ).…”