CT guided stereotactic surgery : an overview of 600 procedures

The aim of this paper is to present our experience with CT guided stereotaxy, documenting the types of procedures performed and their outcome. Over the past five and a half years, 600 stereotactic procedures have been performed using the Brown Roberts Wells (BRW) stereotactic system. The procedures were categorized as (i) diagnostic biopsies : 431; (ii) Therapeutic procedures (Aspirations) : 52; (iii) functional procedures: 13; and (iv) stereotactic craniotomies: 104. False negative or nondiagnostic biopsies were obtained in 28 out of 431 diagnostic procedures (6.5 percent) and in 3 cases the procedure was terminated without taking a biopsy. Two of 483 patients undergoing stereotactic biopsy or aspiration died due to procedure related complications (0.41 percent). Seven patients had major morbidity associated with this procedure (1.44 percent) and 12 others had transient worsening of neurological status (2.48 percent). All functional procedures were done for movement disorders. Stereotactic craniotomies were performed for excision of small lesions in eloquent areas. Of 600 procedures, the preoperative objective was achieved in 564 cases (94 percent). Stereotactic surgery has very low mortality and morbidity and plays an important role in the management of intracranial lesions.