Brain biopsy in 10 key points – what can a neurologist expect from the neurosurgeon and the neuropathologist?

Czech version

Authors: O. Bradáč; A. Štekláčová; F. Kramář; D. Netuka; V. Beneš
Authors‘ workplace: Neurochirurgická a neuroonkologická klinika 1. LF UK a ÚVN Praha
Published in: Cesk Slov Neurol N 2018; 81(2): 229-234
Category: Neuropathological window
doi: https://doi.org/10.14735/amcsnn2018229

Overview

Brain biopsy represents an important technique in the verification of focal brain processes. Nowadays, either framebased or frameless stereotactic biopsies are performed. Open biopsy from a craniotomy is reserved for cases of non-conclusive stereotactic biopsy that demand histological verification of the process which would change the treatment strategy or in case when there is a need for sample for histological examination, i.e. cortical vessel or dura mater. The risk of biopsy is not zero. Therefore, we should always consider the indication for biopsy. Primary biopsy of spinal cord is not indicated.

Key words:
brain biopsy – frambased biopsy – frameless biopsy – histology

Sources

1. Khatab S, Spliet W, Woerdeman PA. Frameless image-guided stereotactic brain biopsies: emphasis on diag-nostic yield. Acta Neurochir (Wien) 2014; 156(8): 1441– 1450. doi: 10.1007/ s00701-014-2145-2.

2. Bradac O, Steklacova A, Kramar F et al. Stereotaktické biopsie mozkových patologií systémem Varioguide – zkušenosti ze 101 výkonů. Cesk Slov Neurol N 2016; 79(5): 579– 584. doi: 10.14735/ amcsnn2016579.

3. Dammers R, Haitsma IK, Schouten JW et al. Safety and efficacy of frameless and frame-based intracranial biopsy techniques. Acta Neurochir (Wien) 2008; 150(1): 23– 29. doi: 10.1007/ s00701-007-1473-x.

4. Gempt J, Buchmann N, Ryang YM et al. Frameless image-guided stereotaxy with real-time visual feedback for brain biopsy. Acta Neurochir (Wien) 2012; 154(9): 1663– 1667. doi: 10.1007/ s00701-012-1425-y.

5. Bradac O, Vrana J, Jiru F et al. Recognition of anaplastic foci within low-grade gliomas using MR spectroscopy. Br J Neurosurg 2014; 28(5): 631– 636. doi: 10.3109/ 02688697.2013.872229.

6. Widhalm G, Minchev G, Woehrer A et al. Strong 5-aminolevulinic acid-induced fluorescence is a novel intraoperative marker for representative tissue samples in stereotactic brain tumor biopsies. Neurosurg Rev 2012; 35(3): 381– 391. doi: 10.1007/ s10143-012-0374-5.

7. Patil AA. A modified stereotactic frame as an instrument holder for frameless stereotaxis: Technical note. Surg Neurol Int 2010; 1: 62. doi: 10.4103/ 2152-7806.70957.

8. Fukaya C, Sumi K, Otaka T et al. Nexframe frameless stereotaxy with multitract microrecording: accuracy evaluated by frame-based stereotactic X-ray. Stereotact Funct Neurosurg 2010; 88(3): 163– 168. doi: 10.1159/ 000313868.

9. Sutherland GR, Wolfsberger S, Lama S et al. The evolution of neuroArm. Neurosurgery 2013; 72 (Suppl 1): 27– 32. doi: 10.1227/ NEU.0b013e318270da19.

10. Amin DV, Lozanne K, Parry PV et al. Image-guided frameless stereotactic needle biopsy in awake patients without the use of rigid head fixation. J Neurosurg 2011; 114(5): 1414– 1420. doi: 10.3171/ 2010.7.JNS091493.

11. Bekelis K, Radwan TA, Desai A et al Frameless robotically targeted stereotactic brain biopsy: feasibility, diagnostic yield, and safety. J Neurosurg 2012; 116(5): 1002– 1006. doi: 10.3171/ 2012.1.JNS111746.

12. Ringel F, Ingerl D, Ott S et al. VarioGuide: a new frameless image-guided stereotactic system-accuracy study and clinical assessment. Neurosurgery 2009; 64 (5 Suppl 2): 365– 371. doi: 10.1227/ 01.NEU.0000341532.15867.1C.

13. Geppert M, Ostertag CB, Seitz G et al. Glucocorticoid therapy obscures the diagnosis of cerebral lymphoma. Acta Neuropathol 1990; 80(6): 629– 634.

14. Herrlinger U, Schabet M, Bitzer M et al. Primary central nervous system lymphoma: from clinical presentation to diagnosis. J Neurooncol 1999; 43(3): 219– 226.

15. Manoj N, Arivazhagan A, Mahadevan A et al. Central nervous system lymphoma: patterns of incidence in Indian population and effect of steroids on stereotactic biopsy yield. Neurol India 2014; 62(1): 19– 25. doi: 10.4103/ 0028-3886.128272.

16. Dorward NL, Paleologos TS, Alberti O et al. The advantages of frameless stereotactic biopsy over frame-based biopsy. Br J Neurosurg 2002; 16(2): 110– 118.

17. Gralla J, Nimsky C, Buchfelder M et al. Frameless stereotactic brain biopsy procedures using the Stealth Station: indications, accuracy and results. Zentralbl Neurochir 2003; 64(4): 166– 170.

18. Woodworth GF, McGirt MJ, Samdani A et al. Frameless image-guided stereotactic brain biopsy procedure: diagnostic yield, surgical morbidity, and comparison with the frame-based technique. J Neurosurg 2006; 104(2): 233– 237.

19. Shooman D, Belli A, Grundy PL. Image-guided frameless stereotactic biopsy without intraoperative neuropathological examination. J Neurosurg 2010; 113(2): 170– 178. doi: 10.3171/ 2009.12.JNS09573.

20. Grossman R, Sadetzki S, Spiegelmann R et al. Haemorrhagic complications and the incidence of asymptomatic bleeding associated with stereotactic brain biopsies. Acta Neurochir (Wien) 2005; 147(6): 627– 631.

21. Ali Z, Prabhakar H, Bithal PK et al. A review of perioperative complications during frameless stereotactic surgery: our institutional experience. J Anesth 2009; 23(3): 358– 362. doi: 10.1007/ s00540-009-0759-y.

22. Salmaggi A, Simonetti G, Trevisan E et al. Perioperative thromboprophylaxis in patients with craniotomy for brain tumours: a systematic review. J Neurooncol 2013; 113(2): 293– 303. doi: 10.1007/ s11060-013-1115-5.

23. Schott JM, Reiniger L, Thom M et al. Brain biopsy in dementia: clinical indications and diagnostic approach. Acta Neuropathol 2010; 120(3): 327– 341. doi: 10.1007/ s00401-010-0721-y.