title: Stereotactic biopsy with electrical monitoring for deep-seated brain tumors.
abstract: OBJECTIVE
  The stereotactic biopsy is widely integrated into clinical practice as an efficient and safe procedure for histologic diagnoses. However, the surgical risk increases when the lesions are close to the eloquence of the adjacent brain. The present report describes two patients with deep-seated brain tumors who underwent a stereotactic biopsy with electrical monitoring and demonstrates the importance of this technique.
  
  
  METHODS
  The tentative target and trajectory were determined on a stereotactic map from the Schaltenbrand and Wahren atlas. A Cosman-Roberts-Wells stereotactic frame was applied to the patient. Electrical recording along a single trajectory was used to identify the circumscribed neuronal structures, and electrical simulation was administered to the target. The biopsy point was decided when no adverse events were observed with a low electric current level.
  
  
  RESULTS
  A 34-year-old male patient with anaplastic astrocytoma in the putamen and thalamus and an 81-year-old female patient with malignant lymphoma in the midbrain underwent stereotactic biopsies with electrical monitoring. The biopsies were successfully performed without any resulting neurologic deficits.
  
  
  CONCLUSIONS
  This report describes two patients with deep-seated brain tumors who underwent stereotactic biopsies with electrical recording and stimulation. The electrical monitoring appears to be a useful technique to complement the ordinary image-guided biopsy.
authors.affiliation: Department of Neurosurgery, Oita University, Faculty of Medicine, Oita, Japan. ohba@med.oita-u.ac.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ooba
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Abe
authors.forename: Yasutomo
authors.initials: Y
authors.lastname: Momii
authors.forename: Minoru
authors.initials: M
authors.lastname: Fujiki
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D001254:Astrocytoma / Q000473:pathology*; D001706:Biopsy / Q000379:methods*; D001921:Brain / Q000473:pathology*; D001931:Brain Mapping / Q000379:methods; D001932:Brain Neoplasms / Q000473:pathology*; D046690:Deep Brain Stimulation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008636:Mesencephalon / Q000473:pathology; D016343:Monitoring, Intraoperative / Q000379:methods; D011699:Putamen / Q000473:pathology; D013238:Stereotaxic Techniques; D013788:Thalamus / Q000473:pathology