Ostertag C B, Mennel H D, Kiessling M
Surg Neurol. 1980 Oct;14(4):275-83.
Stereotactic biopsies from deep-seated brain tumors were carried out in 302 patients. There were more men (58 percent) than women. Peak of prevalence was in the second to fourth decade; the youngest patient was 18 months old. The tumors were deep-seated hemispheric in 36 percent, in the basal ganglia in 30 percent, in the diencephalic region, i.e., hypothalamus and suprachiasmatic region, in 21 percent, and in the midbrain and pineal region in 13 percent. The majority of lesions were gliomas (71 percent), the remaining being epithelial and various nonglial tumors. Operative mortality was 2.3 percent; transient deterioration was observed in 3 percent. Diagnosis was made instantly by cytological examination (smear preparations) and confirmed by conventional histological examination. In only 5 percent of the gliomas was a discrepancy found between the diagnosis from the smear preparation and the subsequent histological diagnosis. Integrating computerized tomography (CT) imaging techniques into the stereotactic technique makes it possible to take biopsies at exact and reproducible sites and with low risk. The findings suggest that exploratory craniotomies, risky free-hand punctures, and aspirations deep in the brain can no longer be advocated. No radiation treatment should be considered without histological confirmation.
对302例深部脑肿瘤患者进行了立体定向活检。男性患者（58%）多于女性。发病高峰在第二至第四个十年；最年轻的患者为18个月大。36%的肿瘤位于深部半球，30%位于基底神经节，21%位于间脑区域，即下丘脑和视交叉上区域，13%位于中脑和松果体区域。大多数病变为胶质瘤（71%），其余为上皮性和各种非神经胶质瘤肿瘤。手术死亡率为2.3%；3%的患者出现短暂性病情恶化。通过细胞学检查（涂片制备）立即做出诊断，并通过传统组织学检查得到证实。仅5%的胶质瘤在涂片制备诊断与后续组织学诊断之间存在差异。将计算机断层扫描（CT）成像技术整合到立体定向技术中，使得能够在精确且可重复的部位进行活检，且风险较低。研究结果表明，不再提倡进行探索性开颅手术、危险的徒手穿刺以及脑深部抽吸。未经组织学证实，不应考虑进行放射治疗。
