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Lahey Health is now part of Beth Israel Lahey Health

by EBSCO Medical Review Board

Definition

A brain biopsy is a surgery to remove a small piece of brain tissue for testing. The tissue may be removed with:

  • Stereotactic biopsy—A computer is used to help locate where the biopsy will be taken, so only a small hole will be needed
  • Burr hole—A small hole called a burr is made in the skull over the biopsy area
  • Craniotomy—A piece of skull is taken out and then put back in after the biopsy is taken

Reasons for Procedure

This procedure is done to diagnose problems with the brain, such as:

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

  • Excess bleeding
  • Problems from anesthesia, such as wheezing or sore throat
  • Infection
  • Blood clots
  • Brain swelling
  • Damage to brain which may cause:
    • Vision problems
    • Problems with balance
    • Bowel and bladder problems
    • Changes in memory, behavior, thinking, or speech
    • Seizures
    • Paralysis or weakness
  • Heart attack

Things that may raise the risk of problems are:

What to Expect

Prior to Procedure

The surgical team may meet with you to talk about:

  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
  • Fasting before surgery, such as avoiding food or drink after midnight the night before
  • Whether you need a ride to and from surgery
  • Tests that will need to be done before surgery, such as a neurological exam and images of the brain

Anesthesia

The doctor may give:

Description of the Procedure

Stereotactic Brain Biopsy

A small incision and a burr hole will be made in the skull. A thin needle will be inserted using a computer. The computer will help guide the needle to the correct spot. The needle will be used to remove tissue from the brain. Staples or stitches may be used to close the area. A bandage will put on the area.

Craniotomy

An incision will be made in the scalp. Part of the skull will be removed. The tissue that covers the brain will be opened. A small sample of brain tissue will be removed. The tissue that covers the brain will be closed and stitched. The skull piece will be returned to its spot. Staples or stitches will be used to close the area. A bandage will be wrapped around the head.

Immediately After Procedure

After surgery, you will be taken to the recovery room to be monitored.

How Long Will It Take?

It will take 1 or more hours. It depends on the type of surgery being done.

Will It Hurt?

Pain and swelling are common in the first week. Medicine and home care help.

Average Hospital Stay

The usual length of stay is 1 to 2 days. If you have any problems, you may need to stay longer.

Post-procedure Care

At the Hospital

Right after the procedure, the staff may:

  • Give you medicine to ease pain and lower the risk of seizures
  • Check your brain function often

During your stay, the hospital staff will take steps to lower your risk of infection, such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

There are also steps you can take to lower your risk of infection, such as:

  • Washing your hands often and reminding visitors and staff to do the same
  • Reminding staff to wear gloves or masks
  • Not letting others touch your incisions
At Home

It can take a month or more to fully heal. Physical activity will be limited during this time. You will need to ask for help with daily activities and delay return to work.

Call Your Doctor

Call the doctor if you are not getting better or you have:

  • Signs of infection, such as fever and chills
  • Pain that you cannot control with medicine
  • Redness, swelling, a lot of bleeding, or any discharge from the incision
  • Headache that does not go away
  • Nausea and vomiting
  • Changes in balance, strength, or movement
  • Changes in vision
  • Loss of bladder or bowel function
  • Problems with thinking

Call for medical help right away if you have:

  • Seizures
  • Shortness of breath
  • Chest pain
  • Loss of consciousness

If you think you have an emergency, call for medical help right away.

RESOURCES

American Brain Tumor Association  http://www.abta.org 

National Brain Tumor Society  http://www.braintumor.org 

CANADIAN RESOURCES

Brain Tumor Foundation of Canada  http://www.braintumour.ca 

Canadian Cancer Society  http://www.cancer.ca 

References

About stereotactic brain biopsy. University of Florida Department of Neurosurgery website. Available at: https://neurosurgery.ufl.edu/patient-care/fac-clin-spes/stereotactic-brain-biopsy. Accessed July 19, 2021.

Image-guided biopsy. University Hospital Southampton website. Available at: https://www.uhs.nhs.uk/OurServices/Brainspineandneuromuscular/Neurosurgery/Diagnosisandtreatment/Braintumours/Image-guidedbiopsy.aspx. Accessed Juy 19, 2021.

Lukas RV, Mrugala MM. Pivotal therapeutic trials for infiltrating gliomas and how they affect clinical practice. Neuro-Oncology Practice, Volume 4, Issue 4, December 2017, Pages 209–219. Available at: https://doi.org/10.1093/nop/npw016 [Epub ahead of print]. Accessed. July 19, 2021.

Stereotactic brain biopsy. American Association of Neurological Surgeons website. Available at: https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Stereotactic-Brain-Biopsy. Accessed July 19, 2021.

Your surgery guide: Information about your craniotomy or biopsy for a brain tumor. Cedars Sinai Medical Center website. Available at: https://www.cedars-sinai.org/programs/neurology-neurosurgery/clinical/brain-tumor/surgery-guide.html. Accessed July 19, 2021.

Revision Information

  • Reviewer: EBSCO Medical Review Board Rimas Lukas, MD
  • Review Date: 07/2021
  • Update Date: 07/19/2021