Diagnosis and Treatment of Brainstem Mass Lesions by CT-Guided Stereotactic Surgery

Abstract

Current neuroradiographic techniques including computed tomographic scanning (CT) and magnetic resonance imaging (MRI) when added to the clinical neurologie examination can localize precisely even small lesions within the brainstem. While the clinical-radiographic diagnosis is accurate with respect to locale, it is often in error with respect to the pathologic nature of the solitary brainstem lesion. Therefore, empiric treatment without the benefit of a tissue diagnosis will often be inappropriate. CT-guided stereotactic surgery can safely and reliably provide a tissue diagnosis in such cases. Furthermore, in selected cases, therapeutic interventions can be of substantial and lasting benefit to the patient.

Stereotactic Biopsy for Brainstem Lesions: A Meta-analysis with Noncomparative Binary Data

“…Despite the refined sensitivity and specificity of modern neuroimaging technologies, only relying on imaging results to diagnose brainstem lesions gives rise to a nonnegligible misdiagnosis rate, ranging from 10% to 20%. [7][8][9][10][11] With the popularity of molecularly targeted therapy for cancers, the selection of well-matched targeted agents is dependent on the biologically diagnostic outcome of tumor samples;…”

Stereotactic Computed Tomography-guided Biopsy of Brainstem Lesions

“…This method is considered the least invasive surgical procedure, with low morbidity and mortality rates in obtaining brain tissue samples. 3,8,9,[19][20][21][22][23][24][25][26][27][28][29] Several publications have shown that a stereotactic biopsy of the lesions on the brainstem performed by an experienced team and guided by modern imaging equipment can be as effective and safe as in any other location of the brain. 3,8,9,[19][20][21][22][23][24][25][26][27][28][29] Several publications have shown that a stereotactic biopsy of the lesions on the brainstem performed by an experienced team and guided by modern imaging equipment can be as effective and safe as in any other location of the brain.…”

Ct-Guided Stereotactic Biopsy of Intrinsic Brainstem Lesions

“…12,17,19,20 These trajectories avoid intracranial vessels and cranial nerves. 1,6,17 Image guided stereotactic brainstem biopsy is highly reliable in terms of positive histological diagnosis and low incidence of morbidity and mortality. 6,7,8,10,15,16,18 In our series histological diagnosis was made in 100% of cases.…”

“…Stereotactic biopsy of brainstem lesions, is now a well established surgical technique and has become a routine Neurosurgical procedure in many centers. 1,6,8,[9][10][11][12][13][14][15][16][17][18][19][20]…”