Some prosectors use hammer and chisel to remove the skull-cap.
This is a bad method, particularly so in the case of medicolegal
autopsies, as artificial fractures of the skull may thus be produced.
It is safest never to use a hammer in the opening of the skull.
The skull-cap is examined as soon as taken off. If the periosteum
was not previously removed it is now scraped off, and the skull-cap
examined against the light. After its complete examination the
operator proceeds to the removal of the brain.
2. =Removal of the Brain.= The convexity of the dura is first
examined. The narrow-bladed brain-knife or long section knife
(Fig. 3) is now taken in hand, and with the cutting edge directed
upward the point of the blade is inserted into the anterior end
of the superior longitudinal sinus and the sinus cut open as far
posteriorly as the opening in the cranial vault will admit. Its
walls and contents are then examined. With cutting edge outward the
point of the brain-knife is then inserted through the dura just to
the left of the anterior end of the falx and the dura cut around to
the left at the level of the horizontal saw-cut. The knife is then
inserted through the dura just to the right of the falx and the
dura cut in the same way on the right side. The two halves of the
dura are now loosened from the convexity of the brain by breaking
the blood-vessels connecting the dura with the inner meninges. The
index-finger is swept over the convexities and along the sides of
the longitudinal sinus, tearing the pial veins. Pathologic adhesions
should be carefully worked out. The finger is then used to raise
the falx anteriorly so that the point of the brain-knife can be
introduced beneath it to cut it upward and forward. The dura is then
carefully examined and turned back over the brain and allowed to hang
down over the occiput. The inner meninges over the exposed portion of
the brain are now examined; and the brain is then removed as follows:
The four fingers of the left hand are placed beneath the frontal
lobes, lifting these sufficiently for the prosector to be able to cut
the I, II, III, IV and VI cranial nerves, the carotids and pedicle of
the hypophysis down to the tentorium cerebelli. The tentorium is then
cut with the tip of the brain-knife, which is held perpendicularly,
by a gentle up-and-down sawing motion, from left to right along the
superior border of the petrous bones. The V, VII, VIII, IX, X, XI
and XII cranial nerves are then cut as closely as possible to their
exits. As they are cut the brain is lifted gradually more and more,
and supported by the left hand. When all the connections have been
cut except the cord and vertebral arteries these are severed by the
myelotome (Fig. 4), or by the brain-knife, the point of which is put
down through the foramen magnum as far as possible, and the cord and
vertebral arteries severed by a transverse cut made from left to
right as nearly horizontal as possible. The knife is now laid aside
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