What is involved in a brain biopsy?

Brain biopsy is a procedure in which a fragment of tissue is taken for analysis in order to make a diagnosis. In this post, the experts in neurosurgery at the Instituto Clavel, tell you all about this procedure.

Biopsy is a diagnostic method in which a sample of tissue is taken from different areas of the body for analysis in order to determine whether there is a pathology or not and what kind it might be. In the case of brain biopsy, a small hole is made in the skull to obtain brain tissue.

This technique is a way to avoid carrying out a more complex operation to obtain the sample, thus minimizing risks and hospitalization time. It is an appropriate measure when it is suspected that there may be a tumor that does not require surgery, which can be treated with radiation therapy.

What cases is it used for?

Since it is a diagnostic technique, brain biopsy allows us to rule out different possibilities and determine the nature of the problem affecting the patient: tumor, inflammation, infection, stroke, etc.

In addition, as we said, this method is very effective when there is a suspicion that the lesion to be analyzed may not require surgery, but can be solved with another type of treatment. It is also very useful when there are several lesions, in order to avoid, as far as possible, having to do various operations.

However, the technique used for brain biopsy is not performed exclusively to obtain tissue, but is also performed to remove the contents of a cyst or deep abscess, since conventional surgery could pose a greater risk.

What does the procedure involve?

Before performing the biopsy, it is necessary to determine the precise point for tissue extraction. To achieve this, the patient undergoes an MRI with special sequences to be used with the brain neuronavigation system. With this information, the path of entry and the hole to be made are planned prior to surgery, to be as minimally invasive as possible. In this way we will be able to know the exact coordinates of the lesion to be treated.

After the MRI, the extraction process takes place in the operating room. There, the fusion of the magnetic resonance image with the position of the patient is carried out using the neuronavigator S7 (medtronic). In this way, we will be able to “navigate” in real time and know at all times the location of the needle we use and the location of the lesion. The technique is usually performed with only local anesthesia on the skin, as neither the skull bone nor the brain have nerve endings, and thus do not feel pain. However, there may be cases where sedation or general anesthesia is required.

The biopsy is performed with a very fine needle and the resulting wound is closed with various stitches. Once extracted, the samples are sent for analysis and the result is generally ready in a week.

Recovery after a brain biopsy

In most cases the intervention is performed under local anesthesia, so the patient can usually go home the same day. The stay in the hospital will depend on the patient’s state of health prior to the biopsy, so if the patient is suffering from an illness, it is likely that they will have to remain hospitalized until they recover.

While the patient is in the hospital, the medical team in charge will provide information and instructions regarding aftercare and medication in each case. The stitches will be removed one week after the test is done.

Obviously, treatment after the biopsy will depend on the diagnosis. The neurosurgeon will inform the patient about the next steps to follow depending on the results of the biopsy

Risks of the procedure

Although this is a safe technique that usually has no complications, like any surgery, there are complications to bear in mind. The following are the most common: 

  • Leakage of cerebrospinal fluid from the wound. In most cases this is a minor complication that can be easily resolved. 
  • Local infection in the area where the biopsy was performed. Usually this is a minor problem. 
  • Hemorrhage: as in any biopsy, there is a risk of hemorrhage occurring during the procedure, because it is possible that an artery or vein might be affected, causing bleeding. In the case of brain biopsy, a hemorrhage can cause mild or severe nerve damage.

At Instituto Clavel we have the cutting-edge tools and the latest technology to carry out this type of intervention. We know that the patient may feel nervous before undergoing the test and that is completely normal, but the truth is that this simple operation does not usually entail risks or have complications. In addition, we have a Preparation, Empowerment, and Recovery program (PER) that will make the medical process easier and reduce stress for the patient.

If you have questions or need more information, contact us to tell us about your case so that we can assist you in a personalized way.

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