Stereotactic exploration of deep-seated or surgically unamenable intracranial space-occupying lesions

Stereotactic biopsy of surgically unamenable intracranial lesions has been performed in our Neurosurgical Division since 1977. Riechert's apparatus is employed. An originally developed biopsy instrument and its advantages are described. Stereotactic coordinates of the biopsy site are found by CT scanner data using the technique described earlier by us. The series consists of 20 patients in whom a variable number of biopsy samples (from 1 to 5) was taken. Mortality and morbidity were nil. In 2 cases the stereotactic exploration led to a therapeutic maneuver: a cystic craniopharingioma and a cerebellar hematoma were extirpated. The clinical, neurological and histological features of 5 paradigmatic cases are illustrated. The relevance of histological diagnosis for adequate treatment is stressed. The indications for this surgical procedure are discussed.