Shoshan Y, Pomeranz S H, Sofer D, Ashkenazi E, Israel Z, Umansky F
Dept. of Neurosurgery, Hadassah-University Hospital, Ein Kerem, Jerusalem.
Harefuah. 1995 Apr 16;128(8):470-4, 528.
During a 3-year period starting in 1991, 49 patients with brain lesions underwent 50 stereotactic brain biopsy procedures. The average age was 46 years (range 4-74). Specimens were taken from various brain regions, particularly from the deep aspect of the cerebral hemispheres and midline structures. The pathologic entities included 27 gliomas (13 glioblastomas, 6 astrocytomas, 3 anaplastic astrocytomas, 1 pilocytic astrocytoma and 4 oligodendrogliomas), 5 lymphomas, 2 germinomas, 1 primitive neuroectodermal tumor, 2 metastatic tumors and 11 non-neoplastic lesions (4 demyelination, 2 infarcts, 1 hematoma, 1 brain abscess, 1 radiation necrosis, 1 Alzheimer's disease and in 1 case no diagnosis). The diagnostic success of the stereotactic brain biopsies in this series was 96% (in 98% of the patients). The mean hospital stay was 3 days. 1 patient with a multifocal bilateral glioblastoma died due to early postoperative hematoma of the basal ganglia (2%). Another 2 patients underwent craniotomy due to post-biopsy hematoma. They continued to suffer from hemiparesis after discharge. Transient Horner's syndrome was noted in 1 patient. Thus the permanent morbidity rate was 4%. We conclude that stereotactic brain biopsy can be performed relatively safely, has a high diagnostic yield, and facilitates planning of treatment.
从1991年开始的3年期间，49例脑病变患者接受了50次立体定向脑活检手术。平均年龄为46岁（范围4 - 74岁）。标本取自脑的各个区域，特别是大脑半球深部和中线结构。病理类型包括27例胶质瘤（13例胶质母细胞瘤、6例星形细胞瘤、3例间变性星形细胞瘤、1例毛细胞型星形细胞瘤和4例少突胶质细胞瘤）、5例淋巴瘤、2例生殖细胞瘤、1例原始神经外胚层肿瘤、2例转移瘤和11例非肿瘤性病变（4例脱髓鞘、2例梗死、1例血肿、1例脑脓肿、1例放射性坏死、1例阿尔茨海默病，1例未明确诊断）。本系列立体定向脑活检的诊断成功率为96%（98%的患者）。平均住院时间为3天。1例多灶性双侧胶质母细胞瘤患者因术后早期基底节区血肿死亡（2%）。另外2例患者因活检后血肿接受了开颅手术。出院后仍有偏瘫。1例患者出现短暂性霍纳综合征。因此永久致残率为4%。我们得出结论，立体定向脑活检可以相对安全地进行，具有较高的诊断率，并有助于治疗方案的制定。
