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Brain biopsy in cryptogenic neurological disease
Claire M Rice1, Catherine E Gilkes, Emily Teare
1Department of Neurology, Frenchay Hospital, Bristol, UK.
British Journal of Neurosurgery
|April 20, 2011
Summary
Diagnostic brain biopsies for unexplained neurological conditions are safe and effective. This procedure significantly aids diagnosis and alters patient management, suggesting it should not be a last resort.
Area of Science:
- Neurosurgery
- Neurology
- Pathology
Background:
- Brain biopsy is standard for suspected central nervous system (CNS) malignancy.
- Its utility in cryptogenic neurological disease is less established.
- This study evaluates diagnostic brain biopsies in a UK center from 2003-2008.
Purpose of the Study:
- To review indications, complications, and outcomes of diagnostic brain biopsies.
- To assess the value of brain biopsy in cryptogenic neurological disease.
- To determine if brain biopsy should remain a last resort procedure.
Main Methods:
- Retrospective analysis of 432 brain biopsies (2003-2008).
- Focus on 56 biopsies in 52 patients with cryptogenic neurological disease.
- Exclusion of cases with clear pre-operative malignancy or infection diagnoses.
Main Results:
- No permanent deficits or deaths occurred.
- Definitive or suggestive histopathology was obtained in 65% of cases.
- Biopsy contributed to diagnosis in 55% and management was altered in 63% of patients.
- Targeted biopsies were significantly more diagnostic (78%) than non-targeted ones (29%).
Conclusions:
- Brain biopsy for cryptogenic neurological disease carries low risk.
- The procedure significantly impacts diagnosis and management decisions.
- Brain biopsy should be considered beyond a last resort option for these cases.
