Authors: Johanna QuickWeller Stephanie Lescher Markus Bruder Nazife Dinc Bedjan Behmanesh Volker Seifert Lutz Weise Gerhard Marquardt
Publish Date: 2016/06/13
Volume: 129, Issue: 2, Pages: 243-250
Abstract
Stereotactic biopsies are procedures performed to obtain tumor tissue for diagnostic examinations Cerebral lesions of unknown entities can safely be accessed and tissue can be examined resulting in correct diagnosis and according treatment Stereotactic procedures of lesions in highly eloquent regions such as the brainstem have been performed for more than two decades in our department In this retrospective study we focus on results approaches modalities of anesthesia and complications We performed a retrospective analysis of our prospective database including 26 patients who underwent stereotactic biopsy of the brainstem between April 1994 and June 2015 All of the patients underwent preoperative MRI Riechert–Mundingerframe was used before 2000 thereafter the Leksell stereotactic frame was used After 2000 entry and target points were calculated by using BrainLab stereotactic system We evaluated histopathological results as well as further treatment additionally we compared complications of local versus general anesthesia and complications of a frontal versus a transcerebellar approach Median age of all patients was 33 years and median number of tissue samples taken was 12 In all patients a final histopathological diagnosis could be established 5 patients underwent the procedure under local anesthesia 21 patients in general anesthesia In 19 patients a frontal approach was performed while in 7 patients a transcerebellar approach was used Complications occurred in five patients Thereby no significant difference was found with regard to approach frontal versus transcerebellar or anesthesia local versus general Stereotactic biopsies even of lesions in the brainstem are a save way to obtain tumor tissue for final diagnosis resulting in adequate treatment Approach can be transcerebellar or frontal and procedure can be performed either under local or general anesthesia without significant differences concerning complication rate
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