Clinical Centre of Vojvodina, Novi Sad Neurosurgery Clinic Clinical Centre of Vojvodina, Novi Sad Serbia The value of Frame-based CT guided stereotactic biopsy in the treatment of different brain tumors M. Karan MD P. Vulekovic MD PhD Dj. Jajic MD PhD T. Cigic Md PhD V. Papic MD PhD Dj. Djilvesi MD B. Jelaca MD

Introduction Frame-based stereotactic brain biopsy is an effective way for acquiring histological diagnosis. This diagnostic method reach all brain locations It is appropriate for patients of all ages and medical conditions

Aim To evaluate results of the stereotactic biopsy in tretament of different intracranial lesions in our facility

Material and methods Retrospective research at the Clinical Center of Vojvodina From January 2009 to December 2012 61 patients with different intracranial lesions Age ranged from 16 to 81, mean age of 70,15 years CT guided stereotactic biopsy in the general anesthesia

Material and methods Indications Hystological diagnosis of deep intrinsic lesion Diffuse, infiltrative or multiple lesions Hystological diagnosis of intracranial lesion in patients in poor medical condition Decompression and hystological diagnosis of cystic lesion

Material and methods Preoperative preparation: Laboratory tests Frame placement CT scan contrast agent Coordinates Transffer to the operating theater Laboratory tests CT scan MRI, MRS Informed consent

Material and methods Standard Lexel stereotactic frame modified by Karl-Dieter Lerch CL instruments GmbH, Germany

Material and methods Patient positioning Partialy hair shaving 14mm Burr hole Aspiration biopsy 8-10 bits, side-cutting Sedan needle Frozen section PH analisys Paraffine embedded specimens Control CT scan

Results Thalamus was the most common location (58%) of lesion. Diagnostic yield was 100% There were no transient or permanent neurological deficits after the procedure Patients were discharged usually on the 4th or 5th postoperative day.

Complications There were no transient or permanent neurological deficits after the procedure Karnofsky performance index was unchanged in all of our patients

Conclusion Frame-based stereotactic biopsy is safe and reliable procedure in the diagnosis and management of brain lesions