Clinical Analysis of CT-Guided Stereotactic Brain Biopsy

Park, Jin Sam; Paeng, Sung Hwa; Kim, Moo Seong; Lee, Sun Il; Jung, Yong Tae; Sim, Jae Hong

Original article

Journal of the Korean Society of Stereotactic and Functional Neurosurgery 2005;1(1):85-89.
Published online June 30, 2005.

Clinical Analysis of CT-Guided Stereotactic Brain Biopsy

Jin Sam Park, Sung Hwa Paeng, Moo Seong Kim, Sun Il Lee, Yong Tae Jung, Jae Hong Sim

Department of Neurosurgery, Inje University College of Medicine, Busan Paik Hospital, Busan, Korea

Abstract

Objective
Treatment strategies for intracranial lesions are most effect when based upon histopathological diagnosis. Stereotactic brain biopsy has played an integral role in the accurate diagnosis and management of brain lesions, and has provided the means to sample tissue from small or deep seated intraaxial lesions with relatively high degree of safety and accuracy. Although procedure complications are infrequent,devastating neurologic sequelae may results. Therefore, author analyzed factors that may influence the risk of hemorhage and the diagnostic accuracy rate.
Methods
Author reviewed 64 patients who done stereotactic brain biopsy in the department of neurosurgery at Busan Paik Hospital, Inje University between January 1990 and December 2001. All patients was performed postbiopsy brain CT. According to the clinical progress, CT scan was follow-up. All patients were reviewed of all medical charts, preoperative laboratory finding and pathologic diagnosis. We analyzed for correlation of postoperative cerebral hemorrhage or swelling. In all biopsy cases, CRW system (Radionics) was used with either brain magnetic resonance (1.5T Gyroscan, ACS-NT philips) or brain CT (Simens, Somatom plus) image guidance for stereotactic lesion localization.
Results
In 64 patients, 5 patients (7.8%); hemorrhage, 5 patients (7.8%)'swelling, 7 patients (10.9%); neurological deficits were developed. The permanent sequelae developed in 3 patients (4.7%) and a patient (1.6%) died. In case of preoperative platelet count was below 150,000/mm3, the postbiopsy hemorrhage risk was high. In deep seated tumor and malignant glioma, the frequency of the complications were high.
Conclusion
Stereotactic brain biopsy was relatively low-risk and safety. However, unexpected complications can happen. Therefore, all stereotactic biopsy patients should be close observed postoperatively, especially the patients having low platelet count (<150,000/mm3), deep seated tumor and malignant glioma.

Key Words: CT scan, Stereotactic brain biopsy, Complication, Cerebral hemorrhage, Cerebral swelling.