gms | German Medical Science

64th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

26 - 29 May 2013, Düsseldorf

Stereotactic biopsy of brainstem lesions in adults: A single-centre experience from 37 consecutive cases

Meeting Abstract

  • Christopher Beynon - Neurochirurgische Klinik, Universitätsklinikum Heidelberg
  • Alexander Radbruch - Neuroradiologische Klinik, Universitätsklinikum Heidelberg
  • Andreas W. Unterberg - Neurochirurgische Klinik, Universitätsklinikum Heidelberg
  • Karl L. Kiening - Sektion Stereotaktische Neurochirurgie, Neurochirurgische Klinik, Universitätsklinikum Heidelberg

Deutsche Gesellschaft für Neurochirurgie. 64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Düsseldorf, 26.-29.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. DocDI.10.12

doi: 10.3205/13dgnc262, urn:nbn:de:0183-13dgnc2626

Published: May 21, 2013

© 2013 Beynon 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: Brainstem tumors account for only 2% of all brain tumors in the adult population and in the majority of cases, surgical resection is not possible. The indication of performing a stereotactic biopsy in order to establish a definite diagnosis has been a matter of debate due to the high eloquence of this region. The objective of this study was to characterise the surgical modalities and risks associated with stereotactic biopsy of brainstem lesions. Furthermore, the diagnostic yield of this procedure and the characteristics of pre-operative magnetic resonance imaging (MRI) are analysed.

Method: The medical records of 37 consecutive adult patients who underwent a stereotactic biopsy of a brainstem lesion at our institution were retrospectively analysed.

Results: In 25 patients (68%), the brainstem lesion was targeted through a frontal approach while a suboccipital approach was chosen in 12 patients (32%). A definite histopathologic diagnosis was established in 35 out of 37 patients (94.5%). Histopathologic examination revealed brainstem glioma in 23 patients (low-grade: n=7; high-grade: n=16). Other diagnoses included inflammation (n=4), lymphoma (n=3), metastasis (n=1), abscess (n=1), chordoma (n=1), tuberculoma (n=1), and radiation necrosis (n=1). In two patients (5.4%), no histopathologic diagnosis was established. The surgical mortality was 0%. In three patients (8%), postoperative neurologic deficits occurred which resolved completely during the further course. One patient (2.7%) suffered from permanent abducens palsy postoperatively.

Conclusions: The results of this series add to the growing body of evidence that stereotactic biopsy of brainstem lesions in adults is a safe and effective procedure. The heterogeneous profile of diagnoses underscores that a histopathologic diagnosis should be established prior to initiating treatment protocols.