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Manoj N, Arivazhagan A, Bhat DI, et al. Stereotactic biopsy of brainstem lesions: Techniques, efficacy, safety, and disease variation between adults and children: A single institutional series and review. J Neurosci Rural Pract. 2014;5(1):32-9doi: 10.4103/0976-3147.127869.
Manoj, N., Arivazhagan, A., Bhat, D. I., Arvinda, H. R., Mahadevan, A., Santosh, V., Devi, B. I., Sampath, S., & Chandramouli, B. A. (2014). Stereotactic biopsy of brainstem lesions: Techniques, efficacy, safety, and disease variation between adults and children: A single institutional series and review. Journal of neurosciences in rural practice, 5(1), 32-9. https://doi.org/10.4103/0976-3147.127869
Manoj, N, et al. "Stereotactic biopsy of brainstem lesions: Techniques, efficacy, safety, and disease variation between adults and children: A single institutional series and review." Journal of neurosciences in rural practice vol. 5,1 (2014): 32-9. doi: https://doi.org/10.4103/0976-3147.127869
Manoj N, Arivazhagan A, Bhat DI, Arvinda HR, Mahadevan A, Santosh V, Devi BI, Sampath S, Chandramouli BA. Stereotactic biopsy of brainstem lesions: Techniques, efficacy, safety, and disease variation between adults and children: A single institutional series and review. J Neurosci Rural Pract. 2014 Jan;5(1):32-9. doi: 10.4103/0976-3147.127869. PMID: 24741247; PMCID: PMC3985354.
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J Neurosci Rural Pract. 2014 Jan;5(1):32-9. doi: 10.4103/0976-3147.127869.

Stereotactic biopsy of brainstem lesions: Techniques, efficacy, safety, and disease variation between adults and children: A single institutional series and review.

Journal of neurosciences in rural practice

N Manoj, A Arivazhagan, D I Bhat, H R Arvinda, A Mahadevan, V Santosh, B Indira Devi, S Sampath, B A Chandramouli

Affiliations

  1. Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India.
  2. Department of Neuro Imaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India.
  3. Department of Neuropathology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India.

PMID: 24741247 PMCID: PMC3985354 DOI: 10.4103/0976-3147.127869

Abstract

BACKGROUND: Stereotactic biopsy of brainstem lesions have been performed with varying indications, with most of the literature reporting on children.

MATERIALS AND METHODS: The present study retrospectively analyzed all cases that underwent stereotactic biopsy for brainstem lesion in both adult and pediatric population between 1994 and 2009 in a single tertiary neurosurgical center. The clinical and radiological features, technique of the procedure, morbidity, diagnostic accuracy, spectrum of diagnosis, and variations in adult and pediatric population were analyzed.

RESULTS: Eighty-two patients were included in the study. Computed tomography (CT) was used as guidance in 73 (38 children and 35 adults) patients and magnetic resonance imaging (MRI) in 9 (3 children and 6 adults). The biopsy was performed in a procedure room under local anesthesia in most adults, while children required sedation. Glioblastoma comprised 29.3% of all pathologies in children, compared with only 4.9% of the pathologies in adult population (P = 0.007). Tuberculosis was the next major diagnosis (9.8%). In 12 patients, initial biopsy was inconclusive. Following a repeat biopsy in 5 of these patients, a diagnosis was possible for 75/82 (91.5%) patients by STB. The location of the target, the choice of entry, the radiological characteristic of the lesion, enhancement pattern, and age group did not significantly correlate with the occurrence of inconclusive biopsy. Permanent complications occurred in two patients (2.4%). There was no mortality in this series.

CONCLUSION: Stereotactic biopsy has an important role in brainstem lesions, more significantly in adults, due to wider pathological spectrum. It can be performed safely under local anesthesia through a twist drill craniostomy in most of the adults.

Keywords: Age group difference; brainstem lesion; pathology; pediatric; stereotactic biopsy

References

  1. J Neurooncol. 2008 Jun;88(2):175-83 - PubMed
  2. Acta Neurochir (Wien). 1992;116(2-4):164-70 - PubMed
  3. J Neurosurg. 2000 Dec;93(6):951-7 - PubMed
  4. Childs Nerv Syst. 2004 Mar;20(3):143-53 - PubMed
  5. J Neurosurg. 1995 Jun;82(6):976-81 - PubMed
  6. Childs Nerv Syst. 2010 Jan;26(1):29-34 - PubMed
  7. Pediatr Neurosurg. 1996;24(5):252-5 - PubMed
  8. J Chin Med Assoc. 2011 Mar;74(3):110-4 - PubMed
  9. Surg Neurol. 1995 Jun;43(6):563-7; discussion 567-8 - PubMed
  10. Neurosurgery. 2013 Jun;72(6):873-81; discussion 882; quiz 882 - PubMed
  11. Cancer. 1998 May 1;82(9):1749-55 - PubMed
  12. Surg Neurol. 2005;64 Suppl 2:S82-8 - PubMed
  13. Neurosurgery. 1987 Jun;20(6):930-7 - PubMed
  14. Pediatr Radiol. 2006 Sep;36(9):959-64 - PubMed
  15. Neurosurgery. 1985 Jul;17(1):12-8 - PubMed
  16. Surg Neurol. 2006 Nov;66(5):484-90; discussion 491 - PubMed
  17. Neurosurgery. 1993 Dec;33(6):1026-9; discussion 1029-30 - PubMed
  18. Stereotact Funct Neurosurg. 2003;81(1-4):5-9 - PubMed
  19. Brain. 2001 Dec;124(Pt 12):2528-39 - PubMed
  20. Semin Ultrasound CT MR. 2010 Jun;31(3):246-59 - PubMed
  21. Stereotact Funct Neurosurg. 2010;88(6):360-6 - PubMed
  22. Stereotact Funct Neurosurg. 2012;90(2):79-83 - PubMed
  23. Surg Neurol. 1995 Jun;43(6):558-62 - PubMed
  24. J Neurosurg. 1986 Dec;65(6):751-5 - PubMed
  25. Neurosurgery. 2008 Sep;63(3):460-6; discussion 466-8 - PubMed
  26. Br J Neurosurg. 2008 Aug;22(4):599-601 - PubMed
  27. Neurosurgery. 1978 May-Jun;2(3):217-22 - PubMed
  28. Brain Tumor Pathol. 2006 Oct;23(2):71-5 - PubMed
  29. J Pediatr Neurosci. 2009 Jan;4(1):17-9 - PubMed
  30. J Neurol Neurosurg Psychiatry. 2009 Oct;80(10):1134-9 - PubMed
  31. Acta Neurochir (Wien). 1999;141(7):721-6; discussion 726-7 - PubMed
  32. Neurosurg Clin N Am. 1990 Jan;1(1):111-21 - PubMed
  33. J Neurooncol. 1999 May;42(3):205-13 - PubMed
  34. J Neurosurg. 1989 Feb;70(2):195-200 - PubMed
  35. Acta Neurochir (Wien). 2005 Jan;147(1):47-9; discussion 49-50 - PubMed
  36. J Neurosurg. 1999 Oct;91(4):569-76 - PubMed
  37. J Neurosurg. 1986 Jan;64(1):11-5 - PubMed

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