brain biopsy


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Brain Biopsy

 

Definition

A brain biopsy is the removal of a small piece of brain tissue for the diagnosis of abnormalities of the brain, such as Alzheimer's disease, tumors, infection, or inflammation.

Purpose

By examining the tissue sample under a microscope, the biopsy sample provides doctors with the information necessary to guide diagnosis and treatment.

Precautions

Imaging of the brain is performed to determine the precise positioning of the needle to enter the brain.

Description

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 nineties, 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.

Preparation

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.

Aftercare

The patient is monitored in the recovery room for several hours and is usually required to spend a few days in the hospital since general anesthesia is required.

Risks

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.

Normal results

After examining the brain tissue directly, no abnormalities are detected.

Abnormal results

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.

Key terms

Alzheimer's disease — A progressive, neurodegenerative disease characterized by loss of function and death of nerve cells in several areas of the brain, leading to loss of mental functions such as memory and learning.
Computed axial tomography (CT) — Computed axial tomography (CT) is a x-ray technique that has the ability to image soft tissue, bone, and blood vessels.
Cortex — The thin convoluted surface of the brain comprised primarilyof cell bodies of neurons.
MRI — Magnetic resonance imaging is an imaging technique that uses radiowaves, magnetic fields, and computer analysis to visualize body tissue and structures.
Stereotactic brain needle biopsy — In this procedure a computer uses information from a CT or MRI to create a three-dimensional map of the operation site to better guide the needle to perform the biopsy.

Resources

Organizations

Alzheimer's Association. 919 North Michigan Ave., Suite 1100 Chicago, IL 60611-1676.(800) 272-3900 http://www.alz.org.
American Brain Tumor Association. 2720 River Road, Suite 146, Des Plaines, IL 60018-4110. (800) 886-2282. 〈http://www.abta.org〉.
National Institute of Neurological Disorders and Stroke, NIH Neurological Institute. P.O. Box 5801 Bethesda, MD 20824. (800) 352-9424. 〈http://www.ninds.nih.-gov/index.htm〉.

brain biopsy

A procedure in which a small piece of brain tissue is obtained transcranially to establish a diagnosis.
  
Indications
Suspected Alzheimer's disease or other neurodegenerative condition, tumours, infection, inflammation, and other brain disorders.
References in periodicals archive ?
9,16] To our knowledge, two cases of pSS and NMOSD that were positive for AQP4 antibodies with only cerebral white matter lesions have been reported to date, and one was proven by brain biopsy to be more compatible with NMOSD than with pSS.
The policy was created based on a report from the Industrial Disease Standards Panel that said causation couldn't be detected from blood or urine levels, and that it would require an autopsy or brain biopsy to determine whether there were neurological effects, Martell noted.
A brain biopsy specimen of cerebral cortex and superficial white matter showed a moderate lymphoplasmacytic and focally histiocytic infiltrate that involved deep cortex, white matter, and leptomeninges.
Stereotactic brain biopsy was performed by the neurosurgery clinic after the result of cranial magnetic resonance imaging (MRI) which showed nodular lesions measuring 1.
The cases in the current study were among children with a clinically compatible illness, and either measles IgG antibody detected in cerebrospinal fluid, a characteristic pattern on electroencephalography, typical histologic findings on brain biopsy, or medical record documentation of SSPE-related complications.
Spearman's rank correlation coefficient was used to evaluate whether there was a correlation between the course of acute, subacute, or chronic manifestations of the disease that may become indicated for stereotactic brain biopsy, and the occurrence of the first disease-related events.
When PCNSL is suspected, a stereotactic brain biopsy from a lesion should be performed in time.
As reported, she hoped to be home in Great Ayton for Christmas, but when her condition worsened after a brain biopsy on December 22, it meant she had to stay in hospital over Christmas and New Year - so now she has her 13th birthday in her sights.
Invasive tests such as brain biopsy are not warranted unless absolutely necessary.
Hence it was decided that tissue diagnosis was necessary and stereotactic brain biopsy was done as there was no lesions else ware in the body.
All clinical samples were collected for subsequent laboratory analyses, including the GM antigen test, and Aspergillus fumigatus and Candida albicans PCR tests, from 194 neutropenic episodes for blood culture, 61 episodes for urine culture, 34 episodes for sputum culture, 12 episodes for catheter culture, two episodes for tracheal aspirate (TRA), and one episode for bronchoalveolar lavage (BAL), throat swab, wound swab, brain biopsy material, and pleural material cultures.
Currently, abnormal collections of these proteins are confirmed only with a brain biopsy or autopsy.