Acta Neurochirurgica

, Volume 143, Issue 6, pp 539–546

The Risk of Haemorrhage after Image Guided Stereotactic Biopsy of Intra-Axial Brain Tumours – A Prospective Study

  • F. W. Kreth
  • A. Muacevic
  • R. Medele
  • K. Bise
  • T. Meyer
  • H.-J. Reulen

DOI: 10.1007/s007010170058

Cite this article as:
Kreth, F., Muacevic, A., Medele, R. et al. Acta Neurochir (Wien) (2001) 143: 539. doi:10.1007/s007010170058

Summary

Objective. To analyze prospectively the frequency and the risk of symptomatic and asymptomatic haemorrhage after image guided stereotactic biopsy of intra-axial brain tumours.

Methods. The study was conducted within a time frame of 24 months (April 1998–April 2000). 326 patients (150 males, 176 females; mean age 56.8 years) were included and 345 computerized tomography (CT)-guided stereotactic biopsies were performed/supervised by a specialized stereotactic neurosurgeon. A modified Riechert Stereotaxy System and a workstation for multiplanar trajectory planning were used in all patients. Serial biopsies (median, 5 samples) were done with small forceps (diameter 1 mm), smear preparations of the biopsy specimens were intra-operatively examined. Frequency, size, and location of any detectable bleeding were analyzed by post-biopsy CT-scan investigation. For risk estimation, logistic regression analysis was performed. The chi-square statistic was used for comparative analysis of the study results with available data from the literature.

Results. A conclusive tissue diagnosis could be achieved in 98%. Overall treatment morbidity was 3.1%. There was no mortality. Haemorrhage related morbidity was 0.9%. Age, Karnofsky score, mass effect of the tumour, tumour histology, tumour location and the number of specimens taken did not have any prognostic significance. The clinically silent bleeding rate was 9.6% and more often seen in patients with high grade gliomas (p=0.03). Both the silent and non-silent bleeding rate were significantly lower as compared to available prospective data in the literature. (p<0.01).

Conclusion. Using multiplanar image guided trajectory planning, small biopsy forceps and intra-operative smear preparations the risk of major haemorrhage related morbidity after stereotactic brain tumour biopsy is extremely low (<1%) in experienced hands.

Keywords: Stereotactic biopsy; intra-axial brain tumours; complications.

Copyright information

© Springer-Verlag Wien 2001

Authors and Affiliations

  • F. W. Kreth
    • 1
  • A. Muacevic
    • 1
  • R. Medele
    • 1
  • K. Bise
    • 2
  • T. Meyer
    • 3
  • H.-J. Reulen
    • 1
  1. 1.Department of Neurosurgery, Klinikum Großhadern, Ludwig-Maximilians-University, Munich, GermanyDE
  2. 2.Institute of Neuropathology, Klinikum Großhadern, Ludwig-Maximilians-University, Munich, GermanyDE
  3. 3.Institute of Radiological Diagnostics, Division of Neuroradiology, Klinikum Großhadern, Ludwig-Maximilians-University, Munich, GermanyDE