Department of Neurosurgery, Oita University, Faculty of Medicine, Oita, Japan.
World Neurosurg. 2013 Jan;79(1):207.e1-5. doi: 10.1016/j.wneu.2010.05.028. Epub 2011 Nov 10.
The stereotactic biopsy is widely integrated into clinical practice as an efficient and safe procedure for histologic diagnoses. However, the surgical risk increases when the lesions are close to the eloquence of the adjacent brain. The present report describes two patients with deep-seated brain tumors who underwent a stereotactic biopsy with electrical monitoring and demonstrates the importance of this technique.
The tentative target and trajectory were determined on a stereotactic map from the Schaltenbrand and Wahren atlas. A Cosman-Roberts-Wells stereotactic frame was applied to the patient. Electrical recording along a single trajectory was used to identify the circumscribed neuronal structures, and electrical simulation was administered to the target. The biopsy point was decided when no adverse events were observed with a low electric current level.
A 34-year-old male patient with anaplastic astrocytoma in the putamen and thalamus and an 81-year-old female patient with malignant lymphoma in the midbrain underwent stereotactic biopsies with electrical monitoring. The biopsies were successfully performed without any resulting neurologic deficits.
This report describes two patients with deep-seated brain tumors who underwent stereotactic biopsies with electrical recording and stimulation. The electrical monitoring appears to be a useful technique to complement the ordinary image-guided biopsy.
立体定向活检作为一种有效的、安全的组织学诊断方法，已广泛应用于临床实践。然而，当病变靠近相邻大脑的功能区时，手术风险会增加。本报告描述了两例接受电监测立体定向活检的深部脑肿瘤患者，并展示了该技术的重要性。
根据 Schaltenbrand 和 Wahren 图谱，在立体定向图上确定暂定靶点和轨迹。将 Cosman-Roberts-Wells 立体定向框架应用于患者。沿单个轨迹进行电记录以识别限定的神经元结构，并对靶点进行电模拟。当在低电流水平下观察到没有不良事件时，决定活检点。
一名 34 岁男性患者，纹状体和丘脑有间变性星形细胞瘤；一名 81 岁女性患者，中脑有恶性淋巴瘤，均接受了电监测立体定向活检。活检均成功进行，无任何神经功能缺损。
本报告描述了两例接受电记录和刺激的深部脑肿瘤患者进行立体定向活检。电监测似乎是一种有用的技术，可以补充普通的图像引导活检。
