[Usefulness of the "P.N." frame in biopsies and stereotactic operations on the brain].

BACKGROUND: Stereotactic biopsy represents the gold standard for tissue diagnosis surgically inaccessible gliomas, tumors and cystic lesions. Tissue samples can be obtained by minimally invasive technique. Moreover, the combination of the neuro-endoscope with stereotactic method is possible.

MATERIAL AND METHOD: 23 patients underwent 43 stereotactic biopsy procedures for diagnosis diffuse, deep-seated and eloquent site tumors at Neurosurgery Department Jagiellonian University in Krakow since February 2003. Stereotactic frame "P.N." type (TatraMed S.r.o.) was used. In one case the combined method was used for third ventriculostomy. The specimen was obtained from the target point of CT scan by the aspiration method under local anesthesia in 17 patients and under general anesthesia in 6 patients. The lesion was located in 9 cases of cerebral hemisphere and basal ganglia, in 8 cases of spreading site, in 5 cases of eloquent area and in 1 case of corpus callosum and third-ventricle.

RESULTS: Material from the stereotactic biopsy has been examined neuropathologically. Astrocytoma II(o) WHO were diagnosed in 6 cases, Astrocytoma III(o) WHO in 11 cases, Astrocytoma IV(o) WHO in 3 cases, Metastatic adenocarcinoma in 1 case and in 2 cases the neoplasm was not found. The diagnosis was histologically confirmed in 91.3%. Emergency craniotomy was performed in one patient. In 3 cases the increased intracranial pressure produced by tumor cysts was reduced by the use of biopsy.

CONCLUSIONS: Our data confirm that the "P.N." frame is useful in stereotactic biopsies and operations even with the use of neuroendoscope. The procedure is safe, easy to follow as a tool for patients with various tumors.