CT-guided stereotactic biopsies ofbrain stem lesions: personal experience and literaturereview

Abstract. Appropriate therapy of brain stem lesions should be guidedby an accurate diagnosis. Clinical evaluation combined withmodern neuroimaging techniques may nowadays approach thediagnosis but not always with accuracy, thus leading toerroneous treatment. We report a series of 11 patients whounderwent stereotactic biopsy for brain stem lesions. In 8patients, the lesion was approached transfrontally. In theremaining 3 patients, the lesion was approached via thesuboccipital transcerebellar route. There was no surgicalmortality. Precise histological diagnosis was achieved in allpatients. Three patients (27.2%) suffered complicationsattributed to the procedure and were successfully treatedconservatively. Histological results were in accordance withpreoperative diagnosis in 9 patients (81.8%). Despite thelimited number of patients, our data suggest that stereotacticbiopsy of brain stem lesions is a safe technique that can obtainadequate tissue for histological diagnosis, thus providing eachpatient with the best available treatment.