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Published in: Acta Neurochirurgica 10/2017

01-10-2017 | Original Article - Neurosurgical Techniques

Target location after deep cerebral biopsies using low-volume air injection in 75 patients. Results and technical note

Authors: Maria A. Poca, Francisco-Ramon Martínez-Ricarte, Dario F. Gándara, Pilar Coscojuela, Elena Martínez-Sáez, Juan Sahuquillo

Published in: Acta Neurochirurgica | Issue 10/2017

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Abstract

Background

Stereotactic biopsy is a minimally invasive technique that allows brain tissue samples to be obtained with low risk. Classically, different techniques have been used to identify the biopsy site after surgery.

Objective

To describe a technique to identify the precise location of the target in the postoperative CT scan using the injection of a low volume of air into the biopsy cannula.

Methods

Seventy-five biopsies were performed in 65 adults and 10 children (40 males and 35 females, median age 51 years). Frame-based biopsy was performed in 46 patients, while frameless biopsy was performed in the remaining 29 patients. In both systems, after brain specimens had been collected and with the biopsy needle tip in the center of the target, a small volume of air (median 0.7 cm3) was injected into the site.

Results

A follow-up CT scan was performed in all patients. Intracranial air in the selected target was present in 69 patients (92%). No air was observed in two patients (air volume administered in these 2 cases was below 0.7 cm3), while in the remaining four patients blood content was observed in the target. The diagnostic yield in this series was 97.3%. No complications were found to be associated with intracranial air injection in any of the 75 patients who underwent this procedure.

Conclusions

The air-injection maneuver proposed for use in stereotactic biopsies of intracranial mass lesions is a safe and reliable technique that allows the exact biopsy site to be located without any related complications.
Literature
1.
go back to reference Balasubrammaniam V, Kanaka TS, Ramanujam PB (1974) Stereotaxic surgery for cerebral palsy. J Neurosurg 40:577–582CrossRefPubMed Balasubrammaniam V, Kanaka TS, Ramanujam PB (1974) Stereotaxic surgery for cerebral palsy. J Neurosurg 40:577–582CrossRefPubMed
2.
go back to reference Dammers R, Haitsma IK, Schouten JW, Kros JM, Avezaat CJ, Vincent AJ (2008) Safety and efficacy of frameless and frame-based intracranial biopsy techniques. Acta Neurochir 150:23–29CrossRefPubMed Dammers R, Haitsma IK, Schouten JW, Kros JM, Avezaat CJ, Vincent AJ (2008) Safety and efficacy of frameless and frame-based intracranial biopsy techniques. Acta Neurochir 150:23–29CrossRefPubMed
3.
go back to reference Dammers R, Schouten JW, Haitsma IK, Vincent AJ, Kros JM, Dirven CM (2010) Towards improving the safety and diagnostic yield of stereotactic biopsy in a single centre. Acta Neurochir 152:1915–1921CrossRefPubMedPubMedCentral Dammers R, Schouten JW, Haitsma IK, Vincent AJ, Kros JM, Dirven CM (2010) Towards improving the safety and diagnostic yield of stereotactic biopsy in a single centre. Acta Neurochir 152:1915–1921CrossRefPubMedPubMedCentral
4.
go back to reference Field M, Witham TF, Flickinger JC, Kondziolka D, Lunsford LD (2001) Comprehensive assessment of hemorrhage risks and outcomes after stereotactic brain biopsy. J Neurosurg 94:545–551CrossRefPubMed Field M, Witham TF, Flickinger JC, Kondziolka D, Lunsford LD (2001) Comprehensive assessment of hemorrhage risks and outcomes after stereotactic brain biopsy. J Neurosurg 94:545–551CrossRefPubMed
5.
go back to reference Furlanetti LL, Monaco BA, Cordeiro JG, Lopez WO, Trippel M (2015) Frame-based stereotactic neurosurgery in children under the age of seven: Freiburg University’s experience from 99 consecutive cases. Clin Neurol Neurosurg 130:42–47CrossRefPubMed Furlanetti LL, Monaco BA, Cordeiro JG, Lopez WO, Trippel M (2015) Frame-based stereotactic neurosurgery in children under the age of seven: Freiburg University’s experience from 99 consecutive cases. Clin Neurol Neurosurg 130:42–47CrossRefPubMed
6.
go back to reference Hlastala MP, Van Liew HD (1975) Absorption of in vivo inert gas bubbles. Respir Physiol 24:147–158CrossRefPubMed Hlastala MP, Van Liew HD (1975) Absorption of in vivo inert gas bubbles. Respir Physiol 24:147–158CrossRefPubMed
7.
go back to reference Kulkarni AV, Guha A, Lozano A, Bernstein M (1998) Incidence of silent hemorrhage and delayed deterioration after stereotactic brain biopsy. J Neurosurg 89:31–35CrossRefPubMed Kulkarni AV, Guha A, Lozano A, Bernstein M (1998) Incidence of silent hemorrhage and delayed deterioration after stereotactic brain biopsy. J Neurosurg 89:31–35CrossRefPubMed
8.
go back to reference Livermore LJ, Ma R, Bojanic S, Pereira EA (2014) Yield and complications of frame-based and frameless stereotactic brain biopsy—the value of intra-operative histological analysis. Br J Neurosurg 28:637–644CrossRefPubMed Livermore LJ, Ma R, Bojanic S, Pereira EA (2014) Yield and complications of frame-based and frameless stereotactic brain biopsy—the value of intra-operative histological analysis. Br J Neurosurg 28:637–644CrossRefPubMed
9.
go back to reference Lobao CA, Nogueira J, Souto AA, Oliveira JA (2009) Cerebral biopsy: comparison between frame-based stereotaxy and neuronavigation in an oncology center. Arq Neuropsiquiatr 67:876–881CrossRefPubMed Lobao CA, Nogueira J, Souto AA, Oliveira JA (2009) Cerebral biopsy: comparison between frame-based stereotaxy and neuronavigation in an oncology center. Arq Neuropsiquiatr 67:876–881CrossRefPubMed
10.
go back to reference Mohyeldin A, Lonser RR, Elder JB (2016) Real-time magnetic resonance imaging-guided frameless stereotactic brain biopsy: technical note. J Neurosurg 124:1039–1046CrossRefPubMed Mohyeldin A, Lonser RR, Elder JB (2016) Real-time magnetic resonance imaging-guided frameless stereotactic brain biopsy: technical note. J Neurosurg 124:1039–1046CrossRefPubMed
11.
go back to reference Skjoth-Rasmussen J, Jespersen B, Brennum J (2015) The use of Brainsuite iCT for frame-based stereotactic procedures. Acta Neurochir 157:1437–1440CrossRefPubMed Skjoth-Rasmussen J, Jespersen B, Brennum J (2015) The use of Brainsuite iCT for frame-based stereotactic procedures. Acta Neurochir 157:1437–1440CrossRefPubMed
12.
go back to reference Soukup J, Zauner A, Doppenberg EM, Menzel M, Gilman C, Young HF, Bullock R (2002) The importance of brain temperature in patients after severe head injury: relationship to intracranial pressure, cerebral perfusion pressure, cerebral blood flow, and outcome. J Neurotrauma 19:559–571CrossRefPubMed Soukup J, Zauner A, Doppenberg EM, Menzel M, Gilman C, Young HF, Bullock R (2002) The importance of brain temperature in patients after severe head injury: relationship to intracranial pressure, cerebral perfusion pressure, cerebral blood flow, and outcome. J Neurotrauma 19:559–571CrossRefPubMed
13.
go back to reference Woodworth GF, McGirt MJ, Samdani A, Garonzik I, Olivi A, Weingart JD (2006) Frameless image-guided stereotactic brain biopsy procedure: diagnostic yield, surgical morbidity, and comparison with the frame-based technique. J Neurosurg 104:233–237CrossRefPubMed Woodworth GF, McGirt MJ, Samdani A, Garonzik I, Olivi A, Weingart JD (2006) Frameless image-guided stereotactic brain biopsy procedure: diagnostic yield, surgical morbidity, and comparison with the frame-based technique. J Neurosurg 104:233–237CrossRefPubMed
14.
go back to reference Yuen J, Zhu CX, Chan DT, Ng RY, Nia W, Poon WS, Ng HK, Mok VC, Wong LK, Cheung TC, Siu DY (2014) A sequential comparison on the risk of haemorrhage with different sizes of biopsy needles for stereotactic brain biopsy. Stereotact Funct Neurosurg 92:160–169CrossRefPubMed Yuen J, Zhu CX, Chan DT, Ng RY, Nia W, Poon WS, Ng HK, Mok VC, Wong LK, Cheung TC, Siu DY (2014) A sequential comparison on the risk of haemorrhage with different sizes of biopsy needles for stereotactic brain biopsy. Stereotact Funct Neurosurg 92:160–169CrossRefPubMed
Metadata
Title
Target location after deep cerebral biopsies using low-volume air injection in 75 patients. Results and technical note
Authors
Maria A. Poca
Francisco-Ramon Martínez-Ricarte
Dario F. Gándara
Pilar Coscojuela
Elena Martínez-Sáez
Juan Sahuquillo
Publication date
01-10-2017
Publisher
Springer Vienna
Published in
Acta Neurochirurgica / Issue 10/2017
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-017-3191-3

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