Turkish Neurosurgery 2017 , Vol 27 , Num 3
Computerized Tomography-Guided Stereotactic Biopsy of Intracranial Lesions: Report of 500 Consecutive Cases
Songul Meltem CAN1,Osman Nuri TURKMENOGLU1,Canan TANIK2, Ender UYSAL3,Baris OZONER4,Saime Ayca KALDIRIMOGLU1,Ahmet Murat MUSLUMAN1,Adem YILMAZ1,Halit CAVUSOGLU5,Cicek BAYINDIR6,Yunus AYDIN5,7
1Sisli Hamidiye Etfal Research and Training Hospital, Clinic of Neurosurgery, Istanbul, Turkey
2Sisli Hamidiye Etfal Research and Training Hospital, Clinic of Pathology, Istanbul, Turkey
3Sisli Hamidiye Etfal Research and Training Hospital, Clinic of Radiology, Istanbul, Turkey
4Erzincan University, Faculty of Medicine, Department of Neurosurgery, Erzincan, Turkey
5Acıbadem University, Acıbadem Fulya Hospital, Clinic of Neurosurgery, Istanbul, Turkey
6Istanbul University, Faculty of Medicine, Department of Neuropathology (Emeritus), Istanbul, Turkey
7Acıbadem Fulya Hospital, Clinic of Neurosurgery, Istanbul, Turkey
DOI : 10.5137/1019-5149.JTN.16280-15.1 AIM: Computed tomography (CT)-guided stereotactic brain biopsy has been performed in our clinic since March 1998. In this prospective study, we examined the patient data undergoing stereotactic biopsy and the results of biopsies in 500 consecutive patients. MATERIAL and METHODS: Between the dates of March 1998 and January 2015, CT-guided stereotactic biopsies were performed by using the Leksell stereotactic frame system (Elekta Instruments EU, Sweden) in 500 patients. A total of 512 procedures were performed in patients consisting of 184 females (36.8%) and 316 males (63.2%), ages ranging from 3 to 81 years (mean 50.40±16.67).

RESULTS: Conclusive histopathological diagnosis was not achieved in 17(3.3%) of 512 procedures. Of the others, 173 (33.8%) were high-grade gliomas, 103 (20.1%) were low-grade gliomas, 36 (7%) were malignant lymphomas, 34 (6.6%) were other types of brain tumors, 82 (16%) were metastasis and 67 (13.1%) were non-tumoral lesions. Complications were occurred in ten cases: 3 tumoral bleedings, 2 hypertensive cerebral hematomas, 2 peroperative convulsions, 1 epidural hematoma, 1 myocardial infarction and 1 brain edema. The patients who developed myocardial infarction and hypertensive thalamic hematoma died. The mortality was 0.4% and morbidity was 1.6% in 512 procedures.

CONCLUSION: CT-guided stereotactic biopsy is a reliable and a safe procedure in cases with intracranial lesions when histopathological diagnosis is required for the appropriate treatment. Keywords : Brain tumors, Computerized tomography, Stereotactic biopsy