Development and Validation of a Human Cadaveric Model for Lobar Intracerebral Hemorrhage.

BACKGROUND AND

OBJECTIVES

To develop and validate an anatomically accurate human cadaveric intracerebral hemorrhage (ICH) model that replicates the radiographic and mechanical properties of spontaneous lobar ICH, enabling training and testing of minimally invasive surgical evacuation techniques.

METHODS

Human-derived thrombi were created using mixtures of banked human packed red blood cells, fresh-frozen plasma, and iodinated contrast. Thrombi with physiologic viscoelastic properties were identified through rheometric analysis benchmarked against patient-derived intraoperative ICH specimens. Fresh, never-frozen cadaveric head-and-neck specimens were obtained via the institutional willed body program. After partial embalming, transorbital surgical corridors enabled clot placement in the frontal, temporal, and parietal lobes, while an infratentorial midline mini-craniotomy was used to insert occipital lobe clots.

RESULTS

Human-derived clots composed of 95% fresh-frozen plasma most closely mimicked the mechanical properties of real ICH specimens. Transorbital and occipital approaches allowed for precise, reproducible hematoma placement. Flat-panel computed tomography imaging provided sufficient radiodensity contrast to delineate the clot from the surrounding brain parenchyma.

CONCLUSION

We report the first human cadaveric lobar ICH model using rheologically validated, surgically implanted human-derived clots. This model provides a reproducible platform for device evaluation, procedural development, and training in minimally invasive surgical evacuation of ICH.