- Rand and Malcolm radiolucent surgical head holder. USA. 1988. This radiolucent surgical head holder stabilized the patient while allowing direct radiographic visualization of the surgical anatomy without compromising view angles or x-ray geometry. The low composite density of the head holder structure permitted complete digital subtraction of the images without residual artifact. This resulted in a significant reduction of image retake, the use of lower concentrations of angiographic contrast media, maintenance of standard patient positioning, and an overall reduction in duration of surgical procedures such as arteriovenous malformations (AVM) aneurysm.