Stereotactic posterior midline approach under direct microscopic view for biopsy of medulla oblongata tumors: technical considerations.
Brain stem
Glioma
Medulla oblongata
Stereotactic biopsy
Journal
Acta neurochirurgica
ISSN: 0942-0940
Titre abrégé: Acta Neurochir (Wien)
Pays: Austria
ID NLM: 0151000
Informations de publication
Date de publication:
07 2021
07 2021
Historique:
received:
01
04
2020
accepted:
30
09
2020
pubmed:
14
10
2020
medline:
21
10
2021
entrez:
13
10
2020
Statut:
ppublish
Résumé
Open and stereotactic transfrontal or transcerebellar approaches have been used to biopsy brainstem lesions. In this report, a stereotactic posterior and midline approach to the distal medulla oblongata under microscopic view is described. The potential advantages and limitations are discussed, especially bilateral damage of the X nerve nuclei. This approach should be considered for biopsy of distal and posterior lesions. We strongly recommend the use of direct microscopic view to identify the medullary vessels, confirm the midline entry point, and avoid potential shift of the medulla. Further experience is needed to confirm safety and success rate of this approach.
Sections du résumé
BACKGROUND
Open and stereotactic transfrontal or transcerebellar approaches have been used to biopsy brainstem lesions.
METHOD
In this report, a stereotactic posterior and midline approach to the distal medulla oblongata under microscopic view is described. The potential advantages and limitations are discussed, especially bilateral damage of the X nerve nuclei.
CONCLUSION
This approach should be considered for biopsy of distal and posterior lesions. We strongly recommend the use of direct microscopic view to identify the medullary vessels, confirm the midline entry point, and avoid potential shift of the medulla. Further experience is needed to confirm safety and success rate of this approach.
Identifiants
pubmed: 33047205
doi: 10.1007/s00701-020-04600-6
pii: 10.1007/s00701-020-04600-6
pmc: PMC8195946
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1965-1968Références
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doi: 10.1634/theoncologist.2011-0335
pubmed: 22382458
pmcid: 3316925
Sanai N, Wachhorst SP, Gupta NM, McDermott MW (2008) Transcerebellar stereotactic biopsy for lesions of the brainstem and peduncles under local anesthesia. Neurosurgery 63:460–466; discussion 466-468. https://doi.org/10.1227/01.NEU.0000324731.68843.74
doi: 10.1227/01.NEU.0000324731.68843.74
pubmed: 18812957
Schaltenbrandt G, Wahren W (1977) Atlas for stereotaxy of the human brain. Thieme, Stuttgart