Stereotactic biopsy of non-neoplastic lesions in adults
Donald M. Whiting, MD
Gene H. Barnett, MDAddress reprint requests to G.H.B., Center for Computer Assisted Neurosurgery, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195.
Melinda L. Estes, MD
Cathy A. Sila, MD
Richard A. Rudick, MD
Samuel J. Hassenbusch, MD, PhD
Charles F. Lanzieri, MD
Stereotactic biopsy of intracranial lesions has been used primarily for the diagnosis of neoplastic lesions. A series of 158 consecutive stereotactic biopsies performed at The Cleveland Clinic Foundation resulted in 28 diagnoses of non-neoplastic disorders (18%). The majority of these were infectious, inflammatory, or demyelinating disorders. Stereotactic biopsy alone was diagnostic in 17 cases (61%), and biopsy in conjunction with clinical and laboratory data established definitive diagnoses in six cases (22%). All 23 definitive diagnoses led to modifications in patient management. Permanent neurologic morbidity occurred in only two patients (7%). We maintain that this procedure is underused. Stereotactic biopsy is safe, accurate, and useful for diagnosis of non-neoplastic neurologic disorders when the diagnosis is unclear by conventional means. In such cases, its use can lead to early diagnosis and treatment.