title: Brain biopsy in the management of neurology patients.
abstract: METHODS
  To evaluate the value of brain biopsy for neurology patients in our unit, we conducted a retrospective audit of neurology patients referred for brain biopsies for non-neoplastic disease from 1993 to 2007.
  
  
  RESULTS
  64 patients [median (range) age 51 (16-74) years] were included. The clinical presentation was diffuse encephalopathy for 40 patients, focal for 13 and multifocal for 11. The biopsy was diagnostic in 34 patients, abnormal but non-diagnostic in 21 and normal in 9. There was a statistically significant association between clinical presentation and biopsy result (p = 0.004); diagnostic biopsies were more common in patients with focal or multifocal clinical presentations. Twenty patients (31%) had alterations of management as a result of their brain biopsy, comprising specific treatment (11 patients) or prognosis/diagnosis of untreatable conditions (9 patients). Diagnoses of treatable conditions included Whipple's disease, tuberculoma, progressive multifocal leukoencephalopathy, and neurosarcoidosis. Five patients (7.8%) had complications.
  
  
  CONCLUSIONS
  Brain biopsy is useful and relatively safe in the management of neurology patients, with a diagnostic yield of 53% in our series; some led to significant changes in management, including treatment of infections. Patients with focal or multifocal presentation are more likely to yield a diagnostic biopsy result.
authors.affiliation: Department of Neurology, The Walton Centre, Liverpool, UK. suiwong@doctors.org.uk
authors.forename: S H
authors.initials: SH
authors.lastname: Wong
authors.forename: M D
authors.initials: MD
authors.lastname: Jenkinson
authors.forename: B
authors.initials: B
authors.lastname: Faragher
authors.forename: S
authors.initials: S
authors.lastname: Thomas
authors.forename: D
authors.initials: D
authors.lastname: Crooks
authors.forename: T
authors.initials: T
authors.lastname: Solomon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy / Q000379:methods*; D001921:Brain / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000175:diagnosis*; D009462:Neurology / Q000379:methods*; D012189:Retrospective Studies; D055815:Young Adult