Document Detail

Stereotactic biopsy of nonpolar tumors in the dominant hemisphere: a prospective study of effects on language functions.
MedLine Citation:
PMID:  9171169     Owner:  NLM     Status:  MEDLINE    
A prospective study of patients undergoing computerized tomography (CT)-guided stereotactic biopsy of nonpolar tumors in the dominant hemisphere was undertaken to determine if stereotactic biopsy caused a deterioration of language functions. Language was assessed using the Western Aphasia Battery (WAB) and the Boston Naming Test (BNT) before and after a biopsy sample was obtained. Of 16 patients studied, five (31%) were dysphasic preoperatively. After the biopsy the Aphasia Quotient (AQ), derived from the WAB, had significantly deteriorated in four (80%) of these patients, whereas in the fifth it remained relatively unchanged. One of these patients with an extensive infiltrating hemispheric oligoastrocytoma subsequently recovered normal language function after radiotherapy. In 10 of the 11 patients who had normal language function preoperatively there were no deleterious changes after biopsy in either the WAB subtest or BNT scores. In the other patient whose WAB score was normal preoperatively, there was a significant deterioration in postoperative AQ. This patient, who declined steroid therapy before and after biopsy, had a glioblastoma multiforme in Wernicke's area. A postoperative CT scan revealed no changes from what was shown on preoperative scan. This clinical study shows that CT-guided stereotactic biopsy of nonpolar tumors in the dominant hemisphere using the Brown-Roberts-Wells system and the Sedan-Nashold biopsy cannula carries a 9% risk (95% confidence intervals 0-26%) of impairing language functions if the patient is not dysphasic preoperatively. If the patient is dysphasic preoperatively, there is a very high risk of aggravating the dysphasia with stereotactic biopsy.
A M Thomson; R Taylor; D Fraser; I R Whittle
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  86     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  1997 Jun 
Date Detail:
Created Date:  1997-06-23     Completed Date:  1997-06-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  923-6     Citation Subset:  AIM; IM    
Department of Clinical Neurosciences, Western General Hospital, Edinburgh, Scotland.
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MeSH Terms
Biopsy / methods*
Brain Neoplasms / pathology*,  psychology*,  radiography
Dominance, Cerebral*
Glioblastoma / pathology,  psychology
Glioma / pathology,  psychology,  radiography
Language Tests
Middle Aged
Neuropsychological Tests
Prospective Studies
Stereotaxic Techniques*
Tomography, X-Ray Computed

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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