What is a brain biopsy?

A brain biopsy is a diagnostic surgical procedure where a piece of brain tissue or a brain tumor is removed from the brain to be examined. 

Types of brain biopsies

There are three types of brain biopsies:

Needle biopsy 
During a needle biopsy, your doctor will drill a small hole into the skull, insert a hollow needle into the incision and extract the abnormal tumor or tissue.

Stereotactic biopsy
A stereotactic biopsy is a minimally invasive procedure that uses 3-D imaging in combination with CT or MRI scans to evaluate tissue from the brain.

Open biopsy
During an open biopsy, your neurosurgeon will perform a craniotomy to expose the brain tumor and obtain the sample. Although open biopsies are the most frequently performed brain biopsy procedure, they are the riskiest and require the longest recovery time.

When is a brain biopsy performed?

A brain biopsy may be recommended to determine if you have a:

  • Benign (non-cancerous) or malignant (cancerous) brain tumor
  • Brain abscess or brain tumor

By understanding what type of brain condition you have, your doctor will be able to develop a more effective treatment plan.

Risks of a brain biopsy

Biopsies are less invasive than an open craniotomy for tumor removal. Complications associated with a brain biopsy include:

  • Swelling in the brain
  • Bleeding in the brain
  • Infection
  • Stroke
  • Blood clots
  • Reaction to anesthesia
  • Seizures
  • Coma

What to expect during a brain biopsy?

A brain biopsy is performed in a hospital operating room (OR) under general anesthesia so you don’t feel anything during the procedure. You will have a head ring placed on your head to hold it in place. When necessary, your doctor may order a CT scan or MRI taken at the same time as the biopsy to locate the abnormal area in the brain.

During needle and stereotactic biopsies, your neurosurgeon will make a small incision, drill a small hole in the skull and insert a small needle into the brain to obtain brain tissue sample. After the sample is obtained and the needle is removed, your surgeon will stitch up the incision.

If you had an open biopsy, the bone flap that was removed in the entry process will be replaced with plates or wires. If your brain is swelling or there is infection, the flap will not be replaced. 

If you have a needle or stereotactic brain biopsy, you typically can go home that day. If you have an open biopsy, you may need to stay overnight for monitoring. If there are complications, you may need to stay in the hospital longer.

Results from a brain biopsy

Your tissue sample will be examined by a neuropathologist to make a diagnosis and determine the tumor type and grade. Results take five to seven days to get back from your doctor.

Recovery from a brain biopsy

Before discharge, your doctor will outline detailed instructions for the safest, quickest recovery. 

Discharge instructions will include:

  • Pain management options – if you are in severe pain, your doctor can prescribe medication to help relieve the pain.
  • Wound care – instructions will include information on how to care for the incision site.
  • Activity level recommendations – most patients can return to their normal activity level soon after the biopsy.
  • Follow-up appointment schedule – your results will be shared at the postoperative visit, and stitches and staples will be removed.

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