Premium
Postoperative intracerebral haematomas following stereotactic biopsies: Poor planning or poor execution?
Author(s) -
Zanello Marc,
Roux Alexandre,
Debacker Clément,
Peeters Sophie,
EdjlaliGoujon Myriam,
Dhermain Frédéric,
Dezamis Edouard,
Oppenheim Catherine,
LechaptZalcman Emmanuèle,
Harislur Marc,
Varlet Pascale,
Chretien Fabrice,
Devaux Bertrand,
Pallud Johan
Publication year - 2021
Publication title -
the international journal of medical robotics and computer assisted surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.556
H-Index - 53
eISSN - 1478-596X
pISSN - 1478-5951
DOI - 10.1002/rcs.2211
Subject(s) - medicine , stereotactic biopsy , biopsy , intracerebral hemorrhage , brain biopsy , radiology , surgery , hematoma , stereotactic surgery , glasgow coma scale
Background Postoperative intracerebral haematomas represent a serious complication following stereotactic biopsy. We investigated the possible underlying causes – poor planning or poor execution – of postoperative intracerebral haematomas following stereotactic biopsies. Methods We performed a technical investigation using a retrospective single‐centre consecutive series of robot‐assisted stereotactic biopsies for a supratentorial diffuse glioma in adults. Each actual biopsy trajectory was reviewed to search for a conflict with an anatomical structure at risk. Results From 379 patients, 12 (3.2%) presented with a postoperative intracerebral haematoma ≥20 mm on postoperative CT‐scan (3 requiring surgical evacuation); 11 of them had available intraoperative imaging (bi‐planar stereoscopic teleangiography x‐rays at each biopsy site). The actual biopsy trajectory was similar to the planned biopsy trajectory in these 11 cases. In 72.7% (8/11) of these cases, the actual biopsy trajectory was found to contact a structure at risk (blood vessel and cerebral sulcus) and identified as the intracerebral haematoma origin. Conclusions Robot‐assisted stereotactic biopsy is an accurate procedure. Postoperative intracerebral haematomas mainly derive from human‐related errors during trajectory planning.