Stereotactic biopsy

What is a biopsy?

A biopsy is performed in patients with difficult to diagnose brain abnormalities and in some brain tumour patients. In patients with brain tumours a biopsy can help find out the tumour type. The sample is sent to the laboratory and examined under the microscope by the pathologist to find out the types of cells that are present.

Before any procedure you will need to have a pre-operative examination. Here you will be asked questions about your general health and will have a physical examination. You will also have routine blood tests and possibly an electrocardiogram (ECG). Please bring a list of your medications with you.

Stereotactic biopsy

This is a biopsy guided by your scans. You may be given a general anaesthetic for this procedure, although some patients have a local anaesthetic. These options will be discussed with you by your consultant before coming into hospital so you know what to expect.  It does not take very long and this means you may be able to go home the same day.

What are the risks?

There are some risks involved with any kind of brain surgery. Your Neurosurgeon will explain the risks involved with a stereotactic biopsy and ask you to sign a consent form. Please ensure you have asked as many questions as you want before completing this form.

Procedure

Once you have been put to sleep safely, a small hole will then be made in the skull. A thin needle is inserted into the brain using information gained from the scans. Samples are then taken and sent to the laboratory to be analysed, these results may take up to 6 weeks. You will be taken back to the ward and kept in for a few hours for observation.

Discharge

You will usually have stitches to the incision in your scalp and these will be taken out by a district nurse, at your GP practice or local treatment room. The ward nurses will refer you and provide further instructions. Please keep the wound clean, you can wash your hair 48 hours after the procedure with octenisan/hibiscrub. If your wound starts to look infected (red, swollen) or anything leaks from the wound, please contact your specialist nurse.

You may also have some swelling around the eyes which develops over 24-48 hours, this is normal and should begin to settle down within a few days.

Following your discharge you will be contacted the next working day by the Clinical Nurse Specialist. They will provide some discharge information. When your histology results return, you will be given an outpatient appointment to come back to receive your results.

I am on anti-coagulant medication will I have to stop taking it?

You will be asked to stop taking your anti-coagulant medication as this can cause bleeding during surgery. This will be discussed with you by your Neurosurgeon during your pre-operative consultation.

Who will I be able to talk to during this time?

You will be able to access the Clinical Nurse Specialist before, during and after your admission to hospital. The Clinical Nurse Specialist provides you with support and advice regarding your procedure. You will also be able to discuss any problems with your Neurosurgeon.

What happens next?

The results of the biopsy will determine what happens next. Possible future treatment will be discussed with you when you receive the biopsy results. Some people find it helps to write down information they are given at the time. You will then have a follow up appointment in the appropriate clinic.

Research

We have an active research programme which aims to help us improve our understanding of brain tumours. When the analysis has been completed there may be tissue left over, which we may be able to use for our research. Any research carried out is subject to the authorisation of a research ethics committee and any personal information is kept confidential. Your consultant or specialist nurse will discuss with you whether you would like any residual tissue to be made available for research. You will be asked to sign a consent form if you agree to the above, which your consultant or specialist nurse will sign with you. If you do not consent to research, the tissue samples will be kept by the Trust for medical records.

Contact details

• Brain tumour Clinical Nurse Specialist team available Monday to Friday 8 am- 4 pm
• TEL: 0151 556 3778
• Via bleep 0151 529 5410 Bleep 5391
• Email address braintumournurses@nhs.net
• Out of hours and weekends please contact nurse in charge of the hospital on 0151 525 3611 Bleep 4556