Contribution of Stereotaxic Biopsy in the Management of Brain Tumors: About 101 Cases

Abstract

Introduction: The advent of Stereotaxic Biopsy (STB) and the development of CT and MRI have improved the management of brain tumours. The aim of this study is to evaluate the role of STB in the management of brain tumors. Material and Methods: Retrospective study from 2000 to 2020 concerning 101 consecutive patients with brain tumours, having benefited from a STB, collected in the neurosurgery departments of the the public hospital establishment of AIT IDDIR and Mustapha and Mustapha BACHA university hospital center. The seat of the lesion is deep or functional (the Rolondic region, hemispherical, basal ganglia, lateral ventricles and brainstem and pineal region). STB was performed under CT guidance in all cases. For pineal tumours, arteriography with venographic time and preoperative MRI has been deemed useful to avoid hemorrhagic complications. Results: In 101 cases, the STB was conclusive on the first attempt (90%). The repetition of the STB made it possible to re-establish a precise diagnosis in (5.94%) It was malignant lesions (70% of the cases). The average age of the patients was 46 years (3 to 72) with a male predominance. The topography of the lesions is: 75.13% in the Rolondic region, Central Gray Nuclei, Brainstem and pineal region; 12.87% in the corpus callosum and lateral ventricles and 12.5% in the eloquent superficial lesion. Postoperative complications are dominated by mortality 5.9% followed by partial epileptic seizure 2.98% and severe neurological disorders 1.98%, bilateral ptosis 1.98% and hemiplegia 0.99%. Perioperative mortality fell from 10.45% before 2005 to 1% after 2006 (Chi-square; p = 0.010). Conclusion: STBs should be staged and repeated in case of inconclusive histology. For small deep lesions STB under MRI conditions is necessary. For pineal tumours, it must be performed by the transtemporal orthogonal approach.