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Stereotactic biopsy

Stereotaxy is used for taking biopsies from deep seated lesions as thalamus, basal ganglia, brain stem. It allows for tissue diagnosis with minimal morbidity.
This patient presented with progressive right sided hemiparesis. MRI showed two ring enhancing lesions in left thalamus. Stereotactic biopsy was done from the lesion which was suggestive of fungal brain abscess. Patient was started on anti-fungal treatment. There was gradual improvement on treatment with resolution of symptoms.
Aids used: CRW stereotactic frame, Framelink planning software, Nashold Biopsy Needle, Neuro-navigation CT / MRI fusion software

Pre-op MRI- left thalamic ring enhancing lesion

Pre-op MRI (coronal) with ring enhancing lesion in left thalamus

Stereotactic frame being applied under local anaesthesia

Trajectory planning on workstation
Dr. Nitin Garg
Follow up MRI with significant resolution of the lesions