Stereotactic biopsy indications [Neurosurgery Wiki]

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====== Stereotactic biopsy indications ======

Frame based [[stereotactic biopsy]] (FSB) remains the 'gold standard' for obtaining diagnostic samples of intracranial lesions to guide therapy. Nevertheless, diagnostic yield is highly variable.

The diagnostic yield from contemporary FSB is high and is dependent predominantly on lesion size.
((Maragkos GA, Penumaka A, Ahrendsen JT, Salem MM, Nelton EB, Alterman RL.
Factors Affecting the Diagnostic Yield of Frame-Based Stereotactic Intracranial
Biopsies. World Neurosurg. 2019 Dec 25. pii: S1878-8750(19)33134-1. doi:
10.1016/j.wneu.2019.12.102. [Epub ahead of print] PubMed PMID: 31883483.
)).

They have limitations with regard to flexibility and patient comfort because of the bulky head ring attached to the patient.

The [[stereotactic biopsy]] with advanced [[image guidance]] represents a safe, reliable and minimally invasive method for pathological diagnosis of intracranial lesions. Moreover, the developments of biochemical imaging gives a new concept to the [[stereotactic biopsy]]
((Tian ZM, Wang YM, Yu X, Zhao QJ, Hui R, Liu R, Li ZC. [Clinical experience of 
stereotactic biopsy for the brain lesions]. Zhonghua Wai Ke Za Zhi. 2010 Oct
1;48(19):1459-62. Chinese. PubMed PMID: 21176652.
)).
----
[[Stereotactic biopsy]] indications:

a) deeply located cerebral [[lesion]]s: especially near [[eloquent]] brain

b) [[brainstem lesion]]s: may be approached through the [[cerebral hemisphere]]
((Hood TW, Gebarski SS, McKeever PE, et al.
Stereotactic Biopsy of Intrinsic Lesions of the Brain
Stem. J Neurosurg. 1986; 65:172–176)).

c) multiple small lesions (e.g. in some [[AIDS]] patients)

d) patient medically unable to tolerate [[general anesthesia]] for [[open biopsy]]

see [[Brain Biopsy for angiitis]].

===== Brain biopsy for Creutzfeldt-Jakob Disease Diagnosis =====
[[Brain biopsy for Creutzfeldt-Jakob Disease Diagnosis]]

===== References =====