A brain biopsy is used to establish a diagnosis in cases of eloquently located space-occupying lesions or unclear neurological processes. A brain biopsy can be performed in various ways.
Stereotactic brain biopsy
Of all brain biopsy techniques, stereotactic brain biopsy offers the highest accuracy and is particularly suitable for small lesions or very eloquently located space-occupying lesions.
Navigation-guided brain biopsy
Navigation-guided brain biopsies can be performed, for example, using the VarioGuide system from Brainlab[^1] and are suitable for less deeply located lesions, as their accuracy does not match that of conventional frame-based stereotaxy.
Open brain biopsy
An open brain biopsy is usually performed to establish a diagnosis in cases of superficial lesions of unclear etiology.
Trajectory planning
The following principles should be observed during stereotactic and navigation-guided brain biopsies:
Avoidance of blood vessels and eloquent areas along the trajectory
Avoidance of traversing Sulci, as smaller vessels are also located there.
Avoidance of the Ventricular system along the biopsy trajectory.