- Department of Neurosurgery, Ibn Sina Hospital, Kuwait City, Kuwait
- Department of Neurosurgery, The Ohio State University Medical Center, Columbus, Ohio, USA
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Medical Center, Columbus, Ohio, USA
Waleed A. Azab
Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Medical Center, Columbus, Ohio, USA
DOI:10.4103/2152-7806.138206Copyright: © 2014 Azab WA. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
How to cite this article: Azab WA, Prevedello DM, Carrau RL. Johannes Vermeer of Delft [1632-1675] and vision in neuroendoscopy. Surg Neurol Int 05-Aug-2014;5:123
How to cite this URL: Azab WA, Prevedello DM, Carrau RL. Johannes Vermeer of Delft [1632-1675] and vision in neuroendoscopy. Surg Neurol Int 05-Aug-2014;5:123. Available from: http://sni.wpengine.com/surgicalint_articles/johannes-vermeer-of-delft-1632-1675-and-vision-in-neuroendoscopy/
Background:Johannes Vermeer of Delft [1632-1675] was one of the greatest Masters of the Dutch Golden Age who was intensely preoccupied with the behavior of light and other optical effects and was entitled “The Master of Light”. He fastidiously attended to the subtleties of visual expression through geometry, composition, and precise mastery of the rules of perspective. It has been our impression that some visual similarity does exist between neuroendoscopic images and some of Vermeer's paintings. Such a relation could be explained by the fact that optical devices are utilized in producing both types of display.
Methods:We reviewed the pertinent medical and art literature, observed some video clips of our endoscopy cases, and inspected digital high resolution images of Vermeer's paintings in order to elaborate on shared optical phenomena between neuroendoscopic views and Vermeer's paintings.
Results:Specific optical phenomena are indeed shared by Johannes Vermeer's works and neuroendoscopic vision, namely light and color effects as well as the rules of perspective.
Conclusion:From the physical point of view, the possibility that a camera obscura inspired Vermeer's artistic creation makes the existence of a visual link between his paintings and the endoscopic views of the intracranial cavity comprehensible.
Keywords: Light, neuroendoscopy, Vermeer, vision
Johannes Vermeer of Delft [1632-1675] was one of the greatest Masters of the Dutch Golden Age and unquestionably the most talented genre painter in Holland during the seventeenth century.[
Sense of reality in Vermeer's works. Left: Detail from The Milkmaid. Note the almost real appearance of the hanging basket, the cupper vessel and the broken glass of the window. (With permission from Rijksmuseum, Amsterdam, The Netherlands). Middle: Detail from The Glass of Wine. Note the reflection of light on the glass and the lady's nail paint. (Photo credit © bpk - Bildagentur für Kunst, Kultur und Geschichte, Berlin - Staatliche Museen, Gemäldegalerie, Berlin - Jörg P. Anders - Johannes (Jan) Vermeer van Delft, Das Glas Wein). Right: Detail from The Little Street. The rusty metal hinges of the wooden window shutters contribute to the wary appearance of the old house. (With permission from Rijksmuseum, Amsterdam, The Netherlands)
Comparably, when endoscopes were used intracranially for the first time, neurosurgeons witnessed a world of unique visual experience that they have never encountered before. Such visual realm subsequently developed into an unprecedented level of definition in displaying pathoanatomical details offered by the state-of-the-art rod-lens endoscopes.[
It has been our impression that some visual similarity does exist between neuroendoscopic images and some of Vermeer's paintings [Figures
Similarity between endocopic views and Vermeer's paintings. Details from The Little Street, Upper and Middle Panels. (With permission from Rijksmuseum, Amsterdam, The Netherlands). The vine tree sloping down onto the open window shutter and the door frame directs the viewer inside the house (Upper Right), as the choroid plexus leads visually into the foramen of Monro in the endoscopic view obtained during an endoscopic third ventriculostomy (Upper Left). The blue color of the thalamostriate vein in the endoscopic view echoes to the color of the vine tree intensifying the sense of optical similarity. Further into the house, a maid is washing at the end of the alleyway and an unused broom is ready to be held in action (Middle Center) simulates the Fogarty's catheter about to penetrate the third ventricular floor down in the depth (Middle Left). Note how the tiny vascular pattern on the surface of the mamillary bodies simulates the rows of weary cobblestone in front of the building (Middle Right) contributing to a sense of slow motion directed towards a deeper level of both scenes. (With permission from Rijksmuseum, Amsterdam, The Netherlands). Lower Left, Details from The Glass of Wine, Staatliche Museen, Gemäldegalerie, Berlin, and an endoscopic view during microvascular decompression for trigeminal neuralgia (Lower right). The subtle grades of white and off-white of the brainstem and trigeminal nerve notably simulate the whites of the head cap and the white garment covering the upper chest and shoulders of the lady. Compare the blood vessels converging into and encircle the trigeminal nerve in the endoscopic view to the postures of the lady's arm encircling her torso. The red hues of the blood vessels against the background color of neural tissue in the endoscopic view and the reds of the dress and its folds greatly enhance the sense of similarity. (Photo credit © bpk - Bildagentur für Kunst, Kultur und Geschichte, Berlin - Staatliche Museen, Gemäldegalerie, Berlin - Jörg P. Anders - Johannes (Jan) Vermeer van Delft, Das Glas Wein)
Additional images with features of similarity. Details from The Milkmaid, upper and lower left. Compare each of the images to the corresponding endoscopic dissection image on the right. In the upper images, the low angle of view of the brain stem with close view resembles the woman's head. Note the woman's lower arm in comparison to the cranial nerve and the convergence into the milk vessel compared the jugular foramen in the endoscopic view. With permission from Rijksmuseum, Amsterdam, The Netherlands
Endoscopic images “come to life” by the same Claire-obscure light as in the paintings of the Baroque masters like Vermeer, but the same phenomena can be seen in paintings by his contemporaries, Rembrandt van Rijn, Jacob van Ruisdael, Frans Hals, and Jan Steen. They also had a remarkable knowledge of the interplay of light and dark, they also often used sharp contrasts as to lead the viewer into the scenery, resulting in vivid scenes full of drama.
Light and color effects in neuroendoscopy and in Vermeer's works
Light and color are basic elements of the process of visualization in neuroendoscopy[
Vermeer had a strong preference for cornflower blue and lead-tin yellow. In the seventeenth century, many pigments had to be imported from far and hence they were expensive, like the ultramarine blue from Afghanistan, the umber (earthy brown) color from Umbria in Italy, indigo from Asian countries such as India, and a very precious yellow pigment made by heating red lead and tin dioxide. This yellow color is famous from the yellow jackets he has painted in several paintings, the most well-known being The Milkmaid.
In endoscopic neurosurgery, the endoscope brings the light source and lens closer to the pathology providing brightly illuminated and detailed panoramic views of the target structure within its intracranial environment [
Examples of intracranial endoscopic procedures. The endoscope brings the light source and lens close to the area of interest and provides brightly illuminated and detailed panoramic views of the target structure within its intracranial environment. (a) Endoscopic endonasal sellar approach in a cadaveric specimen. (b) Endoscopic endonasal excision of a pituitary macroadenoma. Note the demarcation between the pituitary gland and tumor tissue. (c) Endoscopic image of the trigeminal nerve in Mickel's cave during an endoscope-assisted microvascular decompression
The Glass of Wine, Johannes Vermeer, circa 1661-1662, oil on canvas, 65 × 77 cm, Staatliche Museen, Gemäldegalerie, Berlin. (Photo credit © bpk - Bildagentur für Kunst, Kultur und Geschichte, Berlin - Staatliche Museen, Gemäldegalerie, Berlin - Jörg P. Anders - Johannes (Jan) Vermeer van Delft, Das Glas Wein)
Vermeer's depiction of windows through which light flows into his interior scenes is a very special feature of his art[
As high color fidelity contributes to producing true color neuroendoscopic images indispensable for real differentiation between various tissues [
Technical examinations revealed that Vermeer generally applied a gray or ochre ground layer over the canvas to establish the color harmonies of the composition and created translucent effects by applying thin glazes over these layers to achieve such an outstanding luminosity of his works.[
Vision in neuroendoscopy depends largely on the rules of perspective where the view of a given anatomical region or structure is altered by changes in the viewing angle of the lens and the trajectory of the endoscope shaft [
It is notable that Vermeer reinforced the depth of most of his paintings by making use of a foil, a chair, or a curtain. Vermeer had (like his contemporary Gerard de Lairesse) a theoretical interest in painting and a notable interest in maps.
In endoscopic neurosurgery, a customized entry point is determined, which enables reaching a particular intracranial environment, that is, the area in which work is to be performed under direct vision.[
Digital verification of precision
The accurate portrayal of three-dimensional space through perspective has recently been understood to have played a more important role in Vermeer's art than it was previously thought.[
The camera obscura
It has been speculated that Vermeer used a room-type camera obscura to actually trace many of his works from its screen.[
From the physical point of view, the possibility that an optical device like a camera obscura inspired Vermeer's artistic creation makes the existence of a visual link between the atmospheres prevailing in his interiors and the endoscopic views of the intracranial cavity comprehensible. Philosophically, the Dutch interiors that were in reality dim by Vermeer's time became deeply and richly lightened in his works exactly as the previously dark intracranial cavity became vibrantly and beautifully illuminated by the endoscopes. Johannes Vermeer's quest for a clearer view of what he observed and subsequently depicted in his art on one hand and the continued evolution of neuroendoscopy on the other hand are genuine and beautiful representations of the everlasting endeavor of humanity towards a deeper look into the universe.
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