Key Clinical Findings & Highlights
- Achieves 93.3% definitive diagnostic yield for deep-seated brain lesions.
- Demonstrates safety of frameless optical 3D trajectory planning.
- Minimizes patient hospital stay and avoids extensive open craniotomy morbidity.
Abstract
Introduction & Background
Histopathological confirmation and molecular subtyping are imperative before initiating targeted chemotherapy or precision radiotherapy in neuro-oncology. Modern optical tracking neuronavigation allows millimetric trajectory accuracy while avoiding eloquent cortical tracts and deep sulcal vasculature.
Clinical Case Presentation & Diagnosis
Forty-five patients with deep-seated lesions inaccessible to safe craniotomy resection underwent frameless MRI-guided optical stereotactic biopsy. High-resolution volumetric 3D contrast MRI scans were coregistered with the navigation system. Trajectories were planned to traverse non-eloquent gyrus and avoid ventricular ependymal surfaces and vascular vessels.
Surgical Technique & Management
Through a mini-burr hole under local or general anesthesia, a side-cutting biopsy needle was navigated to the target coordinates. Multiple micro-core specimens were acquired and verified with intraoperative squash cytology before skin closure.
Discussion & Literature Context
A positive diagnostic yield was achieved in 93.3% of cases (high-grade gliomas, primary CNS lymphoma, tuberculomas, and demyelinating lesions). The overall post-operative complication rate was low (2.2% asymptomatic micro-hematoma), with zero procedural mortalities.
Conclusion
Neuronavigation-guided biopsy provides an exceptionally safe, reliable, and high-yield surgical technique for definitive histological diagnosis in deep brain pathologies.
How to Cite This Research
A. Chhabra, D. K. Singla, D. K. Singh, Dr. Surendra K. Gupta, M. Kaif, K. Yadav, F. Ahmad (2022). "Efficacy of neuronavigation guided biopsy in deep seated brain lesions". Romanian Neurosurgery, Volume 36, Issue 3, Pages 296-301.
