Stereotactic biopsy of non-neoplastic lesions in adults

Stereotactic biopsy of intracranial lesions has been used primarily for the diagnosis of neoplastic lesions. A series of 158 consecutive stereotactic biopsies performed at The Cleveland Clinic Foundation resulted in 28 diagnoses of non-neoplastic disorders (18%). The majority of these were infectious, inflammatory, or demyelinating disorders. Stereotactic biopsy alone was diagnostic in 17 cases (61%), and biopsy in conjunction with clinical and laboratory data established definitive diagnoses in six cases (22%). All 23 definitive diagnoses led to modifications in patient management. Permanent neurologic morbidity occurred in only two patients (7%). We maintain that this procedure is underused. Stereotactic biopsy is safe, accurate, and useful for diagnosis of non-neoplastic neurologic disorders when the diagnosis is unclear by conventional means. In such cases, its use can lead to early diagnosis and treatment.