title: Stereotactic brainstem biopsy in a patient with coagulopathy of unclear etiology: case report.
abstract: BACKGROUND
  Parenchymal hemorrhage is one of the most feared risks of stereotactic brain biopsies potentially resulting in neurological deficits or even a fatal outcome. Patients with disorders of the coagulation system are at particular risk, so identifying these is one of the main tasks prior to surgery. Some patients may have a bleeding tendency despite normal laboratory values of the hemostatic system.
  
  
  METHODS
  We report the case of a patient with coagulopathy of unclear etiology undergoing a stereotactic brainstem biopsy.
  
  
  CONCLUSIONS
  A medication scheme with tranexamic acid and desmopressin effectively decreased the patient's bleeding time in vivo and the procedure was carried out without complications.
authors.affiliation: Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany. christopher.beynon@med.uniheidelberg.de
authors.forename: C
authors.initials: C
authors.lastname: Beynon
authors.forename: T
authors.initials: T
authors.lastname: Hoffmann
authors.forename: W
authors.initials: W
authors.lastname: Wick
authors.forename: A W
authors.initials: AW
authors.lastname: Unterberg
authors.forename: K L
authors.initials: KL
authors.lastname: Kiening
mesh_terms: D000328:Adult; D000933:Antifibrinolytic Agents / Q000627:therapeutic use; D001254:Astrocytoma / Q000175:diagnosis / Q000188:drug therapy / Q000532:radiotherapy; D001706:Biopsy / Q000379:methods*; D001760:Bleeding Time; D001778:Blood Coagulation Disorders / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology*; D001932:Brain Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000532:radiotherapy; D001933:Brain Stem / Q000473:pathology*; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D019635:Neurosurgical Procedures / Q000379:methods*; D013238:Stereotaxic Techniques; D014148:Tranexamic Acid / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid; D003894:Deamino Arginine Vasopressin