Stereotactic biopsy for brainstem lesion: Comparison of approaches and reports of 10 cases

Background: Stereotactic biopsy for brainstem lesion offers high diagnostic yield with low morbidity. We compared two modalities of biopsy procedure, frame-based and frameless stereotaxy, either transfrontal or transcerebellar route. The benefits and operation considerations are discussed. Methods: Ten patients with intrinsic brainstem lesion diagnosed with stereotactic biopsy from August 2006 to March 2010 were retrospectively reviewed. All procedures were performed under general anesthesia. Six of 10 patients were approached with transfrontal route, whereas the other four patients with transcerebellar route. Frame-based stereotaxy or frameless navigation system was applied. Results: All lesions of the 10 patients were successfully diagnosed with stereotactic biopsy procedure. There was no major morbidity after the procedure. Conclusion: A number of approaches are available for stereotactic brainstem biopsy. Surgical approach should be tailored, according to the location neurological function, with special concern for the patients’ safety. In selected condition, frameless stereotaxy biopsy also provides competed diagnostic yield