[Complications and diagnostic yield of stereotactic biopsy for the patients with malignant brain tumors].
OBJECTIVE
The purpose of this study was to assess the complication risk rate and diagnostic yield in a series of 211 procedures performed by a consistent method at one institute.


METHODS
Two hundred and one patients underwent 211 stereotactic biopsy procedures for diagnosis of malignant brain tumor at Niigata University between 1987-2001. Indication for stereotactic biopsy is decided on the following factors: 1) the patient is elderly or unsuitable for craniotomy; 2) the tumor location is in a deep, diffusing, multiple, eloquent site; 3) cytoreductive surgery is not needed to treat the suspected pathology. The specimen was obtained from the target point of CT scan by the aspiration method under local anesthesia except for in six patients who were children or needed operation for a VP shunt under general anesthesia. The lesion was located in 114 cases of cerebral hemisphere, in 44 cases of basal ganglia, in 11 cases of cerebellum and in 11 cases of spreading site.


RESULTS
Histological diagnosis was obtained in 188 of 211 procedures and the diagnostic yield was 93.5%. There were 104 high grade gliomas, 16 low grade gliomas, 5 germ cell tumors, 37 malignant lymphomas, 19 metastatic tumors and 13 negative/inconclusive biopsies. Sixteen patients incurred complications (7.6%). Four patients (1.6%) suffered intratumoral hemorrhage. Emergency craniotomy was performed in three patients and stereotactic aspiration of hematoma was carried out in one patient. Furthermore, of 12 complications, 9 occurred with the patient showing symptoms of worsening neurological deficit, 2 occurred with general convulsion and 1 occurred with severe facial pain.


CONCLUSIONS
This study provided evidence that stereotactic biopsy was a safe and reliable tool for patients with unresectable malignant brain tumors.
Takahashi
Hideaki
H
Department of Neurosurgery, Brain Research Institute, Niigata University, 1-757 Asahimachidori, Niigata City, Niigata 951-8585, Japan.
Sugai
Tsutomu
T
Uzuka
Takeo
T
Kano
Mizuho
M
Honma
Junpei
J
Grinev
Igor
I
Tanaka
Ryuichi
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000009:adverse effects / Q000379:methods*; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D020300:Intracranial Hemorrhages / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012306:Risk; D013238:Stereotaxic Techniques / Q000009:adverse effects