World Neurosurg
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Closed (percutaneous) brain biopsy is an important diagnostic procedure. Information on patient outcomes after biopsy come largely from single-institution series or population-based samples that include patients treated during periods that may not reflect current neurosurgical practice. We sought to determine the rates of in-hospital mortality and discharge to home after closed brain biopsy, and predictors of these outcomes by using a large population-based hospital discharge database with near-complete case ascertainment. ⋯ Closed brain biopsy is associated with a greater rate of mortality than is generally recognized. Most patients are able to return to home directly after biopsy, but the rate of discharge to home is lower at hospitals with lower procedure volumes.
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The stereotactic biopsy is widely integrated into clinical practice as an efficient and safe procedure for histologic diagnoses. However, the surgical risk increases when the lesions are close to the eloquence of the adjacent brain. The present report describes two patients with deep-seated brain tumors who underwent a stereotactic biopsy with electrical monitoring and demonstrates the importance of this technique. ⋯ This report describes two patients with deep-seated brain tumors who underwent stereotactic biopsies with electrical recording and stimulation. The electrical monitoring appears to be a useful technique to complement the ordinary image-guided biopsy.
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"Open" transcortical and transcallosal approaches allow gross total colloid cyst resection but require a wider surgical corridor through normal brain tissue compared with endoscopic techniques. Although the use of tubular retractor systems has been previously reported, the minimum required diameter size for the retractor tube has been approximately 16 to 22 mm. Our objective was to explore the use of smaller retractor tubes for total resection of colloid cysts. ⋯ Smaller retractor tubes may be used for resection of colloid cysts while minimizing brain retraction injury and potentially improving outcomes.