Stereotactic Biopsy

A CT or MRI scan of your brain has shown an abnormal spot. Your healthcare provider has concerns that this spot might be something, such as a tumor or an infection, that needs treatment. A stereotactic biopsy  is done to make the correct diagnosis, especially when the spot is located in a deep or very important part of your brain. The results from the biopsy will determine whether more treatment is needed.

There are several ways to do stereotactic biopsy. All are very high tech and rely on a brain scan. A point inside the abnormal area on your scan is chosen as the target for sampling. A blunt-tip surgical biopsy needle is attached to a special instrument that helps guide it precisely to the target. Your surgeon will choose the safest path. A small area of your scalp is shaved and cleaned. Using an incision about a quarter inch in length, the biopsy needle is placed through a nail-sized hole made in the skull. When it reaches the target, a small sample of the abnormal area is collected through the hollow needle and sent for identification. The needle is removed and the incision is closed with a stitch, staple or tissue glue.

The risks of stereotactic biopsy are the same as for any surgical procedure. Fortunately, these risks are quite low. The chance of a new neurologic problem resulting from this procedure is very small. Infection is rare. The risk of having a bleed that will cause symptoms is about 1%, and swelling may occur. The advantage to this surgery is that only a small needle is used. It may be difficult to make a firm diagnosis from this tiny sample (this happens only about 1-2% of the time) and the biopsy may need to be done again.

Your neurosurgeon has a lot of experience with this procedure. It is a good idea to bathe and shampoo before your surgery. The biopsy is usually done using anesthesia or occasionally with just sedation. You should stop smoking before any surgery. You will be asked to stop eating eight hours before surgery. You may take sips of clear liquid up to two hours before surgery. Check with your healthcare provider about taking your medicines before surgery. Follow any additional instructions you are given. You usually can expect to stay overnight in the hospital following your surgery.

You will be given specific instructions when you leave the hospital. Most patients can resume their preoperative activities a day or two after surgery. After 24 – 48 hours, you can wash the area using the palm of your hand. Do not scrub your incision. Let it air dry or pat it with a clean towel. 

Barring any problem, recovery should be pretty easy. You may feel a little tired after anesthesia. There may be mild soreness around the incision. Increase your activity as tolerated. Pay attention to how you feel. Call your healthcare provider if you have concerns or questions.