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Brain Biopsy in the Management of Neurology Patients

Wong, S H, Jenkinson, M D, Faragher, Brian, Thomas, S, Crooks, D and Solomon, T (2010) 'Brain Biopsy in the Management of Neurology Patients'. European Neurology, Vol 64, pp. 42-45.

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Abstract

Background and Methods: To evaluate the value of brain biopsy for neurology patients in our unit, we conducted a retrospective audit of neurology patients referred for brain biopsies for non-neoplastic disease from 1993 to 2007. Results: 64 patients [median (range) age 51 (16–74) years] were included. The clinical presentation was diffuse encephalopathy for 40 patients, focal for 13 and multifocal for 11. The biopsy was diagnostic in 34 patients, abnormal but non-diagnostic in 21 and normal in 9. There was a statistically significant association between clinical presentation and biopsy result (p = 0.004); diagnostic biopsies were more common in patients with focal or multifocal clinical presentations. Twenty patients (31%) had alterations of management as a result of their brain biopsy, comprising specific treatment (11 patients) or prognosis/diagnosis of untreatable conditions (9 patients). Diagnoses of treatable conditions included Whipple’s disease, tuberculoma, progressive multifocal leukoencephalopathy, and neurosarcoidosis. Five patients (7.8%) had complications. Conclusions: Brain biopsy is useful and relatively safe in the management of neurology patients, with a diagnostic yield of 53% in our series; some led to significant changes in management, including treatment of infections. Patients with focal or multifocal presentation are more likely to yield a diagnostic biopsy result.

Item Type: Article
Uncontrolled Keywords: Brain biopsy, Cerebral amyloid angiopathy, Progressive multifocal leukoencephalopathy
Subjects: WB Practice of Medicine > Therapeutics > WB 379 Biopsy
WL Nervous System > WL 300 General works (Include works on brain alone)
Faculty: Department: Groups (2002 - 2012) > Clinical Group
Digital Object Identifer (DOI): https://doi.org/10.1159/000315032
Depositing User: Users 43 not found.
Date Deposited: 07 Sep 2010 10:02
Last Modified: 06 Feb 2018 13:00
URI: http://archive.lstmed.ac.uk/id/eprint/1080

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