• Timothy E O'Connor, Andrew J Fabiano, Dheerendra Prasad, Nabiha Morin, and Robert A Fenstermaker.
• Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, State University of New York, Buffalo, New York, USA. Electronic address: toconnor@ubns.com.
• World Neurosurg. 2021 Mar 1; 147: 144-149.

BackgroundBiopsy of pineal region neoplasms is frequently accomplished by way of endoscopic transventricular access or using an image-guided, computer-assisted stereotactic approach.MethodsWe evaluated a nonorthogonal lateral temporal approach for stereotactic biopsy of pineal region tumors as a variation of previously described stereotactic methods. Magnetic resonance imaging-guided frameless stereotaxy was used to plan and perform biopsies of pineal region tumors using a nonorthogonal trajectory extending from the superior or middle temporal gyri through the temporal stem, anterior to the atrium of the lateral ventricle, and posterior to the corticospinal tract.ResultsAll patients had an uncomplicated postoperative course and remained at neurologic baseline. No parenchymal or ventricular hemorrhage was present on postoperative scans. A tissue diagnosis was obtained in all patients.ConclusionsThis method appears to be a safe alternative to stereotactic biopsy using other trajectories and provides adequate tissue for definitive diagnosis.Copyright © 2020 Elsevier Inc. All rights reserved.

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