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KMID : 0359819930220040504
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Journal of Korean Neurosurgical Society
1993 Volume.22 No. 4 p.504 ~ p.511
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CT-Guided Stereotaxis of Intracranial Mass Lesions: Its Complications and Diagnostic Accuracy of Biopsy
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Abstract
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Surgical resection may not be the approprite first treatment for all intracranial mass lesions. Especially for deep or midline lesions. And a precise histopathological diagnosis is mandatory to develop adequate and specific treatments. The advent
of
modern imaging and CT-compatible stereotactic frames has greatly simplified the performance of sterotactic procedure for small and deep seated brain tumors. We present a 44-month experience on 94 stereotactic procedures of intracranial mass
lesions.
Using Brown-Roberts-Wells (BRW) and Cosman-Roberts-Wells (CRW) system. Procedures were undertaken with the patientunder the local anesthesia for biopsy (78 procedures). Cyst aspiration and/or Ommaya reservoir insertion (9 procedures). And
brachytherapy
(5 procedures) and under the general anesthesia for stereotactic-guided microsurgery (2 procedures). Procedural objectives were satisfactorily accomplished with no mortality and an overall complication rate of 8.5% (8 of 94procedures). The
postopertaive
complications were transient and not serious, except aggravation of obstructive hydrocephalus in two cases of lateral ventricular tumors. Specific and correct histological diagnoses were achieved in 73 (94%) of 78 bopsy. We could not obtain a
specific
diagnosis in 3 cases (2 cass of reactive gliosis. 1 case of necrosis). And in two cases with a diagnosis of anaplastic astrocytoma and oligodendroglioma grade I on the basis of surgical specimens by craniotomy. Stereotactic biopsy revealed
astrocytoma
grade II and nonspecific inflammation respectively. Our data suggest that CT-guided stereotactic biopsy is a reliable and safe method for histologic diagnosis of brain-tumoral conditions and the method of choice for deep-seeated and midline
lesions.
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KEYWORD
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