The Use of Transcerebellar Approach with Inverted Frame Setting for Stereotactic Biopsy of Posterior Fossa Lesions

Czech version

Authors: J. Chrastina ^1,2; Z. Novák ^1,2; P. Cejpek ¹; M. Hermanová ³; I. Říha ^1,2; J. Vaníček ^4,5
Authors‘ workplace: Neurochirurgická klinika LF MU a FN U sv. Anny v Brně ¹; CEITEC – Středoevropský technologický institut MU, Brno ²; I. patologicko-anatomický ústav LF MU a FN u sv. Anny v Brně ³; Klinika zobrazovacích metod LF MU a FN u sv. Anny v Brně ⁴; Mezinárodní centrum klinického výzkumu ICRC, Brno ⁵
Published in: Cesk Slov Neurol N 2013; 76/109(1): 86-89
Category: Short Communication

Overview

Structural lesions affecting posterior fossa region represent a less frequent indication for stereotactic biopsy since vital structures are concentrated in a confined space of posterior fossa and an approach is more demanding. Transfrontal (bioptic cannula inserted from frontal trephination), transtentorial (temporoparietal trephination, cannula passing through tentorial center) and direct transcerebellar approaches may all be used for biopsy sampling. The choice of the surgical approach depends on the location of the lesion with respect to the brainstem. The main limitation of the direct transcerebellar biopsy is the location of the frame directly over the suboccipital region that restricts the options for insertion of a cannula. Inverted stereotactic frame fixation can be used to overcome this technical limitation with subsequent cannula insertion below the frame. The paper analyses the use of the modified transcerebellar approach in four patients with lesions of unclear etiology affecting the posterior fossa structures. The modified transcerebellar stereotactic approach enabled safe bioptic sampling in all patients with decisive impact on further treatment.

Key words:
frame-based stereotaxy – biopsy – infratentorial tumor

Acceted for review:
21. 5. 2012

Accepted for print:
25. 7. 2012

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