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Stereotactic Brain Tumor Biopsy and Removal

When patients first meet with Dr. Greenwald to discuss their options for a brain biopsy, it is common for them to feel nervous and apprehensive about the procedure. For over three decades, Dr. Greenwald has helped many patients going through the difficult reality of dealing with a brain tumor, and understands the worry, stress and frustration that patients experience during such uncertain times. This is why he goes to great lengths to make every patient comfortable, honestly describe all the potential risks and benefits of a brain biopsy, and to give patients the support and attention necessary to get through this difficult point in their lives. If you’ve undergone imaging tests that show a possible lesion or tumor, and your doctor suggested a brain biopsy as the next step, please schedule a consultation at our Mountain View or Redwood City practice, and Dr. Greenwald will discuss all of your options with you, and do everything he can to help you.

What is a Stereotactic Brain Biopsy?

A stereotactic brain biopsy is performed when a brain lesion or tumor has been identified by an imaging system, like an MRI or a CT scan, and further study is needed to assess the malignancy of the tumor and the best treatment options. When performing such biopsies, Dr. Greenwald uses the stereotactic method to ensure precise tissue sampling, and in some cases, tumor removal.

Brain biopsy is a very delicate procedure that must be performed with utmost care. One of the methods that allows for the highest precision during this procedure is the stereotactic biopsy method. This approach utilizes a three-point targeting system to accurately determine the coordinates of the tumor or lesion in relation to other structures of the head; much like using X, Y and Z coordinates to determine a point in three-dimensional space.

By using the stereotactic targeting approach during a brain biopsy, the targeting of the tumor or lesion is greatly improved. This allows Dr. Greenwald to take the appropriate tumor tissue samples, while minimizing any potential damage to surrounding healthy brain tissue.

How is the Stereotactic Brain Biopsy Performed?

Stereotactic brain biopsy is typically performed under general anesthesia, though in some cases it may be necessary for the patient to be awake during the procedure (e.g. when the tumor or lesion is located near parts of the brain responsible for vital functions). In either case, Dr. Greenwald ensures that the patient is comfortable and feels no pain or discomfort during the biopsy.

To begin the brain biopsy, small sticky dots (called fiducials) will be attached to the patient’s head. An MRI scan will then be performed to create an accurate three-dimensional map of the patient’s brain, with the sticky markers acting as reference points. This will allow Dr. Greenwald to precisely locate the lesion, by understanding its coordinates in relation to the markers.

To remove the tissue samples, Dr. Greenwald will begin the brain biopsy by shaving a small area of the scalp and making an incision. A small opening will be made in the skull via a burr hole, which will serve as the entry point for the biopsy needle. To ensure the safety of the patient, Dr. Greenwald will also meticulously create a small opening in the meninges: the protective layers of tissue that surround the brain.

Once the area has been prepared for the brain biopsy, a small needle will be inserted into the brain, and guided toward the lesion. When the tip of the needle has reached the intended destination, a small tissue sample will be collected via a needle aspiration technique, which removes the sample by gently suctioning it into the needle. This sample will then be evaluated by a pathologist in the operating room, to make an initial assessment and determine if additional tissue samples may be needed.

After the necessary tissue samples have been removed, the incision is meticulously cleansed and sutured, to ensure the best recovery after the brain biopsy.

Recovery from Brain Biopsy

Dr. Greenwald’s patients typically recover from a brain biopsy within a few days, but often can go home the same day. In some instances, an overnight stay at the hospital may be needed, especially when the patient may have other health issues that may create complications after the biopsy. Although the biopsy is performed to incredibly high standards, it is nonetheless an invasive surgical procedure that puts stress on the body, and a hospital stay may be required in some cases, for monitoring.

Benefits of Stereotactic Brain Biopsy

There are several benefits to performing a stereotactic brain biopsy, with the main advantage manifesting in better-tailored treatment options. The removed tissue samples can be closely examined with a variety of stains, to give your doctors a much deeper insight into whether the lesion is malignant or benign, and what treatment methods are likely to be most effective.

Such insight can significantly improve treatment outcomes, because treatment will be custom-tailored to the unique features of your lesion or tumor.

Side Effects of Stereotactic Brain Biopsy

Although stereotactic brain biopsy has proven to be a highly effective diagnostic tool, the decision to undergo this procedure always lies with the patient. As such, it’s also important to consider possible side effects of a brain biopsy.

Some of the possible side effects of a biopsy include bleeding within the brain, infection, headaches and seizures. However, having performed hundreds of brain biopsies during his career, Dr. Greenwald is highly skilled at minimizing the potential occurrence of these side effects, and goes to great lengths to ensure patient safety above all else.

Stereotactic Tumor Removal

In addition to brain biopsy, the stereotactic technique can be used to accurately plan a full brain tumor removal. It’s important to keep in mind that Dr. Greenwald will only remove those parts of the tumor that can be taken out safely. The parts of the tumor that are too close to vital areas of the brain responsible for speech or mental function will not be surgically removed, to avoid potential brain damage.

Tumor removal is often performed as a means of improving treatments with radiation and chemotherapy. Although it may not be possible to fully remove the tumor, especially if it’s deep within the brain, removing parts of the growth has been shown to improve results of chemotherapy and radiation.

Further, the growth of even benign tumors can place significant pressure on brain structures and push them to a different position. This can cause many symptoms, like headaches, seizures, difficulty with physical movements, and much more. By removing either part, or the entire tumor, such negative symptoms can be significantly reduced, and the quality of life improved.

Your Stereotactic Brain Biopsy Consultation

If your imaging tests show a brain lesion and you are considering a brain biopsy for further testing, please call us at our Mountain View or Redwood City practice to schedule an appointment with Dr. Greenwald. This will give Dr. Greenwald a chance to review your imaging results in detail, discuss your options with you, and provide you with an opportunity to ask questions, so that you can make an educated decision about this procedure.

Please schedule your brain biopsy consultation by calling our Mountain View or Redwood City practice at 650-968-4747. Alternatively, you can also send us a note by clicking the “Request Appointment” button, below.

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