The Surgical Neuroanatomy Lab (SNL) has a dual educational and research role aiming to improve surgical techniques and outcomes by mastering knowledge of relevant surgical neuroanatomy.

Many national and international students, residents, and fellows have conducted training and research at the SNL during the last years. The working philosophy at the SNL is that of Albert L. Rhoton, Jr., MD: meticulous and exquisite anatomical microdissections to better understand the intricacies of the complex anatomy of the human brain and skull base.

The lab has three main research/educational areas: endoscopic skull base anatomy, microsurgical neuroanatomy, and white matter anatomy/brain connectivity/surgical planning.

Research Activities

Endoscopic Skull Base Anatomy

The Expanded Endonasal Approach (EEA) has revolutionized skull base neurosurgery. The EEA has anatomical and technical advantages over open skull base approaches for the treatment of selected lesions. EEA is not minimally invasive but maximally effective for the treatment of a wide variety of skull base lesions. The SNL at University of Pittsburgh has pioneered anatomical work on the area of skull base endoscopy, and its goal is to continue providing landmark contributions to the skull base community. Meticulous knowledge of the ventral skull base anatomy as seen from the endoscopic perspective is critical to apply endonasal endoscopic surgery in an effective and safe manner.

Microsurgical Neuroanatomy

Conventional skull base approaches are being compared with novel endoscopic endonasal approaches to aid in understanding indications and limitations of different but complementary skull base approaches. Contemporary skull base surgeons should combine expertise in open and endoscopic skull base approaches to select the most appropriate approach and technique for each particular case. Emphasis is made on the circumferential conceptualization of the skull base and the selection of “anatomically-favorable” surgical routes.

White Matter Anatomy/Brain Connectivity/Surgical Planning

High-Definition Fiber Tractography (HDFT) has been developed at University of Pittsburgh by the close collaboration between the SNL (Dr. Fernandez-Miranda), Walter Schneider’s Lab (Learning Research and Development Center - Department of Psychology), and the Magnetic Resonance (MR) Research Center. HDFT is arguably the best technology available for non-invasive fiber mapping of the human brain. At the SNL, we conduct dedicated studies of white matter anatomy using fiber micro-dissection techniques and fiber tracking MR-techniques to further validate HDFT. Our ultimate goal is to advance brain-imaging technology to develop a comprehensive structural/functional description of the network elements and connections forming the human brain, so-called The Human Connectome Project.

Additionally, we pursue the clinical application of our innovative fiber mapping techniques for presurgical planning, neurostructural damage assessment, estimation of postsurgical neural pathways damage and recovery, intraoperative navigation, and tracking of postsurgical changes and responses to rehabilitation therapy, to facilitate brain function preservation and recovery in brain surgery patients. This translational neuroscience research, generously supported by The Pittsburgh Foundation, is possible through the combination of the technological, neuro-mathematical, and physics expertise of Schneider’s Lab and the neuroanatomical and neurosurgical expertise of the SNL.

High-Definition Fiber Tractography (HDFT) of the human brain. Major fiber tracts have been reconstructed and colored individually. This innovative imaging technique has been implemented at the University of Pittsburgh allowing for accurate studies of structural brain connectivity in normal subjects and neurosurgery patients. As an example, Arcuate fascicle (red) connects frontal and temporal lobes and relates to language function and working memory. Note the detailed branching pattern of the tract and the precise termination of the fibers in the cortex.