Stereotactic biopsies of brainstem lesions: which approach?

Jaradat, Amer; Nowacki, Andreas; Fichtner, Jens; Schläppi, Janine-Ai; Pollo, Claudio (2021). Stereotactic biopsies of brainstem lesions: which approach? Acta neurochirurgica, 163(7), pp. 1957-1964. Springer Vienna 10.1007/s00701-021-04733-2

[img]
Preview
Text
Jaradat2021_Article_StereotacticBiopsiesOfBrainste.pdf - Published Version
Available under License Creative Commons: Attribution (CC-BY).

Download (6MB) | Preview

BACKGROUND

Stereotactic biopsies for brainstem lesions are frequently performed to yield an accurate diagnosis and help guide subsequent management. In this study, we summarize our experience with different stereotactic approaches to brainstem lesions of different locations and discuss possible implications for safety and diagnostic yield.

METHODS

We retrospectively analyzed 23 adult patients who underwent a stereotactic biopsy for brainstem lesions between October 2011 and December 2019. Depending on the location supra- or infratentorial, trajectories were planned. We assessed the postoperative complications during the hospital stay as well as the diagnostic yield.

RESULTS

A supratentorial transfrontal approach was used in 16 (70%) cases, predominantly for lesions in the midbrain, upper pons, and medulla oblongata. An infratentorial, transcerebellar-transpeduncular approach was used in 7 (30%) cases mainly for lesions within the lower pons. All biopsies were confirmed to represent pathological tissue and a definitive diagnosis was achieved in 21 cases (91%). Three patients (13%) had transient weakness in the contralateral part of the body in the immediate postoperative period, which improved spontaneously. There was no permanent morbidity or mortality in this series of patients.

CONCLUSION

Lesions of various locations within the brainstem can be successfully targeted via either a supratentorial transfrontal or an infratentorial transcerebellar transpeduncular approach. Our high diagnostic yield of over 90% and the low rate of complications underlines the diagnostic importance of this procedure in order to guide the medical management of these patients.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery

UniBE Contributor:

Nowacki, Andreas; Fichtner, Jens; Schläppi, Janine Ai and Pollo, Claudio

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0001-6268

Publisher:

Springer Vienna

Language:

English

Submitter:

Nicole Söll

Date Deposited:

20 May 2021 14:17

Last Modified:

14 Jun 2021 01:33

Publisher DOI:

10.1007/s00701-021-04733-2

PubMed ID:

33538882

Uncontrolled Keywords:

Brainstem Frame-guided Stereotactic biopsy Stereotactic trajectory

BORIS DOI:

10.48350/155913

URI:

https://boris.unibe.ch/id/eprint/155913

Actions (login required)

Edit item Edit item
Provide Feedback