Stereotactic exploration of the brain in the era of computed tomography

Surgical exploration was undertaken in 102 patients with various brain lesions using a stereotactic system coupled with computed tomography (CT) scanning. All patients were referred for stereotactic surgery because of the critical size or location of the lesions and the need to select appropriate postoperative therapy. Histologic diagnoses were obtained in 98 patients (96.1%). Direct therapeutic intervention using the stereotactic technique alone was possible in 26 patients (25.5%). No mortality and no permanent morbidity occurred in this series. Twenty-six patients had brain lesions that were unsuspected by either clinical or neurodiagnostic tests conducted before surgery. Since January 1983, 48 procedures were performed in an operating room equipped with a high-resolution CT scanner that allowed multiplanar imaging before, during, and immediately after surgery. Stereotactic surgery with CT scanning has proved safe and accurate. It is believed that histologic diagnoses must be sought in all patients with symptomatic brain lesions regardless of size or location. "Empiric" forms of therapy are no longer justified in the age of CT scanning.