[Technical and diagnostic difficulties in stereotactic biopsy in children]

The paper presents technical and diagnostic problems associated with stereotactic biopsies in children. Between the years 1992 and 2000, in the Dept. of Neurosurgery, Child's Health Center, we performed 132 stereotactic procedures, including 110 biopsies. In 15 cases bleeding developed from the biopsy site; in this group we performed 3 craniotomies for open haematoma evacuation, 1 child died (mesencephalic glioblastoma multiforme). The remaining 2 children recovered with no additional neurologic sequelae related to this complication. Since 1997 we use the Nashold needle to obtain tissue samples. This enables us to take larger and fewer samples with less risk of bleeding. The biopsy was non-diagnostic in 3 cases. In 1 case we observed a slight movement of the child's head in relation to the stereotactic frame when the patient was moved from the CT-scanner to the operating theater. In order to avoid such problems in the future and to facilitate transposition of heavy and paretic or unconscious patients, we devised a hard board with side handles. Methods designed to overcome these and other difficulties are described.