Computerized tomography—guided stereotactic surgery for brainstem masses: a risk—benefit analysis in 71 patients

摘要: The benefits of the use computerized tomography (CT)-guided stereotactic surgical techniques for management intrinsic brainstem masses diagnosed from clinical evaluation and imaging studies were evaluated vis-a-vis risks involved in 71 consecutive patients. Seventy-two procedures performed. diffuse, involving two or three contiguous segments, 60 patients focal 11 On CT scans, 25 had hypodense nonenhancing masses, isodense 19 ring-enhancing heterogeneously enhancing masses. A positive biopsy was obtained 68 69 (98.5%) undergoing a procedure. In nine (12.6%) with suspected malignant benign pathology (four tuberculomas, epidermoid cysts, one pyogenic abscess, epidermal cyst, case encephalitis). Additionally, fluid cystic could be aspirated eight cases, providing benefit six lesions neoplastic lesions). Thereby, total 13 (18.3%) deemed to have benefited surgery (two included both categories). Patients highest proportion (60% 36.8%, respectively) therefore derived most histological verification. There no procedure-related mortality. One patient (1.4%) suffered permanent morbidity four others (5.6%) transient worsening attributable authors conclude that CT-guided is safe reliable. Histological verification all (especially ring-enhancing) should undertaken identify nonneoplastic lesions. Selected diffuse atypical features may also biopsy. Even these lack enhancement on contrast-enhanced magnetic resonance image, rather than location tumor alone, form basis diagnosing glioma. main value lies identification significant rapid method evacuation contents