Brain biopsy

Brain biopsy
Medical diagnostics
Brain biopsy under stereotaxy.
ICD-9-CM	01.11-01.14
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Brain biopsy is the removal of a small piece of brain tissue for the diagnosis of abnormalities of the brain. It is used to diagnose Alzheimer's disease, tumors, infection, inflammation, and other brain disorders. By examining the tissue sample under a microscope, the biopsy sample provides doctors with the information necessary to guide diagnosis and treatment.

When an abnormality of the brain is suspected, stereotactic (probing in three dimensions) brain needle biopsy is performed and guided precisely by a computer system to avoid serious complications. A small hole is drilled into the skull, and a needle is inserted into the brain tissue guided by computer-assisted imaging techniques (CT or MRI scans). Historically, the patient's head was held in a rigid frame to direct the probe into the brain; however, since the early 1990s, it has been possible to perform these biopsies without the frame. Since the frame was attached to the skull with screws, this advancement is less invasive and better tolerated by the patient. The doctor (pathologist) prepares the sample for analysis and studies it further under a microscope.

A CT or MRI brain scan is done to find the position where the biopsy will be performed. Prior to the biopsy, the patient is placed under general anesthesia.

The patient is monitored in the recovery room for several hours following the biopsy. Neurological assessments are performed once the patient is fully awake and if left without deficit, most patients can be discharged the day after surgery.

The procedure is invasive and includes risks associated with anesthesia and surgery. Brain injury may occur due to removal of brain tissue. The resulting scar left on the brain has the potential to trigger seizures.

Various brain abnormalities can be diagnosed by microscopic analysis of the tissue sample. The pathologist (a physician trained in how disease affects the body's tissues) looks for abnormal growth, changes in cell membranes, and/or abnormal collections of cells. In Alzheimer's disease, the cortex of the brain contains abnormal collections of plaques. If infection is suspected, the infectious organism can be cultured from the tissue and identified. Classification of tumors is also possible after biopsy.