Stereotactic management of midline brain lesions

Eighty-seven patients, aged 10 months to 92 years, with midline brain lesions were treated using stereotactic techniques at our institution between January 1987 and June 1990. A total of 119 stereotactic procedures were performed with no operative mortality. Procedures included 53 biopsies only, 22 endoscopic laser decompressions, 8 stereotactic microsurgical resections, 9 permanent implants of 125I, 12 temporary implants of 125I, 11 cyst aspirations, 2 cystoperitoneal shunts and 2 intracavitary 32P. The morbidity rate was 4.21%. Local anesthesia was used in 106 of the procedures (89%). Accurate diagnosis was achieved in all cases. Image guidance and stereotactic techniques open new frontiers in the diagnostic and therapeutic management of deep-seated midline intraparenchymal lesions.