A Birds Eyeview of Functioning of NIMHANS Brain Bank
Following documents are required from the relatives
- Copy of Death certificate from a Registered Medical Practitioner
- Medical records of patient
- Brain donation card if previously registered
- Photo ID proof of the deceased and proof of relationship of relative signing consent
In NIMHANS Mortuary
- Relatives are explained about the entire procedure which will be followed.
- Documents provided by the family will be scrutinized.
- If documents are in order, signature of first degree relatives (spouses/children/siblings) on Informed consent form for postmortem and brain donation documents are obtained.
- Postmortem procedure will take 1 – ½ hours from time of receipt of the deceased in NIMHANS Mortuary.
- Following post mortem, the body will be handed back to the relatives with due respect, for the final rites and rituals. Care is taken to ensure there is no disfigurement. The body is thoroughly washed, and handed over draped in a clean white cloth.
Following documents should be collected from Mortuary
- Acknowledgement form of brain/spinal cord donation from Brain Bank
- Copy of informed consent signed
- Death certificate (original)
You receive the following documents from Brain Bank
- Thanks giving letter for donation along with Certificate of donation
- Final postmortem report (within 3 months)
- Annual update on information about Brain Bank activities
WHAT DO WE DO WITH BRAIN COLLECTED AT POSTMORTEM?
Step 1: The brain is examined for any abnormalities
Fresh brain extracted following postmortem
View from Bottom
Step 2: The brain is bisected into 2 halves
One half of the brain will be sliced for freezing at -86 deg.
Other half will be fixed in 10% neutral buffered formalin for examination of pathology under microscope.
Slicing the cerebral hemisphere
Coronal sections : One half of the brain is being sliced from front to back (like bread loaf) serially.
Storing of fresh brain tissue
The brain slices are placed carefully in Ziplock cover, each labelled with case number, and anatomical site.
The ziplock bags are placed in a box and stored in a deep freezer that keeps the tissue at -86°Centigrade, awaiting use by researchers.
The Brain Banks freezer rooms. All the freezers are connected to temperature alarm system that are monitored 24/7.
THE other half….
The other half of the brain is immersed in buffer neutral formalin for minimum 3-4weeks. This half of the brain is examined under microscope by a neuropathologist to ascertain if brain tissue is normal or has any disease process and a final diagnosis based on the examination is provided.
THE GRoss examination
To examine the brain, it is first sliced and the interior of the slices are examined.
Sampling the brain
The neuropathologist makes 20-25 blocks of tissue (~2x2cm sized) from different anatomical areas to be studied microscopically. These are the placed into labelled cassettes to “process” the tissues. One of the anatomical areas is being placed in a cassette for processing.
processing the tissue
This tissue cassettes are then put into a” tissue processor” and then “embedded” in molten paraffin wax to produce a “block”. The wax will harden the tissue so that it an be sliced into extremely thin section.
embedding the tissue
A bit of brain tissue is put into a mold and embedded by paraffin wax. To the left is the freezing plate where the blocks are hardening.
sectioning of the tissue
Thin sections are cut from the wax blocks on a microtome.
sectioning of the brain
The tissue sections are spread out on a heated water bath and are collected on to glass slide. These section will be stained with various dyes that to show the microscopic structure of the brain tissue and the assess changes caused by various diseases, if any.
set of strained slides from embedded brain tissue
A set of stained sections taken from the blocks of brain tissue showing grey matter, white matter tracts and other cellular details of the tissue.