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61st Annual Meeting of the German Society of Neurosurgery (DGNC) as part of the Neurowoche 2010
Joint Meeting with the Brazilian Society of Neurosurgery on the 20 September 2010

German Society of Neurosurgery (DGNC)

21 - 25 September 2010, Mannheim

Prediction of clinical relevant haemorrhages after stereotactic operations

Meeting Abstract

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  • Sebastian Eibach - Department of Neurosurgery, University Hospital Frankfurt am Main, Germany
  • Lutz Weise - Department of Neurosurgery, University Hospital Frankfurt am Main, Germany
  • Volker Seifert - Department of Neurosurgery, University Hospital Frankfurt am Main, Germany

Deutsche Gesellschaft für Neurochirurgie. 61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010. Mannheim, 21.-25.09.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocV1673

doi: 10.3205/10dgnc146, urn:nbn:de:0183-10dgnc1463

Published: September 16, 2010

© 2010 Eibach et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: Stereotactic biopsies have a high diagnostic value concerning brain lesions. Often postoperative CT scans are routinely performed in order to rule out intracerebral haemorrhages, even though the risk of a clinical apparent haemorrhage is very low with this procedure. The objective of this study is to find out the importance of these routine CT scans and the predictive value of any intra operative detected bleeding.

Methods: Prospectively 106 patients who underwent stereotactic biopsy were studied in the years 2009–2010. After frame based stereotactic biopsy a CT scan was performed in all patients to detect haemorrhages due to surgery. The incidence and the size of the haemorrhage was evaluated (more or less than 1 cm in diameter). Any intraoperative bleeding was documented and quantified prospectively by the surgeon (single drips, </=10 drips, > 10 drips). The correlation between intraoperative bleeding and postoperative haemorrhage was analysed.

Results: 32 patients (30.2%) had an intraoperative bleeding, 24 (75%) of them in terms of single drips, 6 (18.7.%) with less than 10 drips and 2 (6.3%) with more than 10 drips. In 14 (43.8%) of these patients haemorrhage was also detected in the postoperative CT scan.

All together 21 out of 106 patients (19.8%) showed haemorrhages in their postoperative CT scan. Of these, 18 (85.7%) showed haemorrhages with a diameter of less than 1 cm and 3 (14.3%) with a diameter of over 1 cm. In 15 out of these 21 patients (71.4%) bleeding already occurred intraoperatively. None of the hemorrhages were symptomatic. All of the larger haemorrhages detected on a postoperative CT scan (3 out of 3) showed intraoperative bleeding.

Conclusions: Stereotactic brain biopsies have a low risk for symptomatic haemorrhagic complications. Intraoperative bleedings are more frequent than haemorrhages detected on a postoperative CT scan. An intraoperative bleeding has a sensitivity of 71% and a predictive value of 44% for the detection of haemorrhages on a postoperative CT-scan. So far an intraoperative bleeding has preceded all larger haemorrhages. Therefore we conclude that postoperative CT scans could be restricted to patients who showed intraoperative bleeding.