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Impact of brain biopsy on management of nonneoplastic brain disease

2022Journal article Open access
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dc.contributor.authorSantos, M
dc.contributor.authorRoque, R
dc.contributor.authorRainha Campos, A
dc.contributor.authorAlbuquerque, L
dc.contributor.authorPimentel, J
dc.date.accessioned2022-10-27T20:52:13Z
dc.date.available2022-10-27T20:52:13Z
dc.date.issued2022
dc.description.abstractIntroduction: Diagnostic yield of brain biopsy in neoplastic brain disease is high and its clinical impact is well established. In nonneoplastic brain disease with negative conventional investigation, decision to undergo invasive procedures is difficult due to its inherent risk and known lower diagnostic yield. Research question: What is the clinical impact of brain biopsy results on management of nonneoplastic brain disease ? Material and methods: A multidisciplinary team retrospectively reviewed and included all nonneoplastic brain disease cases submitted to biopsy between 2009 and 2019, in a tertiary hospital in Lisbon. Baseline characteristics were registered, including immunosuppression status, diagnostic workup, and treatment prior to biopsy. Diagnostic yield, clinical impact and in-hospital complication rates were assessed. Results: Sixty-four patients were included, 20 (31.3%) of them immunosuppressed (15 HIV ​+ ​patients). Thirty-five (67.7%) were previously treated with steroids or antiinfectious agents, with higher percentage (93.3%) in the immunosuppressed group. Biopsy results were diagnostic in 46 (71.9%) cases. More frequent diagnosis was infectious in 20 (31.2%), neoplastic in 12 (18.8%) and inflammatory diseases in 8 (12.5%). Brain biopsy resulted on impact on patient's clinical management in 56 (87.5%), of which 37(57.8%) were submitted to treatment change. In-hospital complications were registered in 4 (6.6%) patients. Discussion and conclusion: Brain biopsy had clinical impact, including a change in treatment, in most patients studied, and may be considered a useful diagnostic option in nonneoplastic brain disease. However, associated complication rate is not negligible, and previous thorough workup, patient selection and risk-benefit assessment are important.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationBrain Spine . 2022 Jan 19;2:100863.pt_PT
dc.identifier.doi10.1016/j.bas.2022.100863pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.26/42073
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.subjectBiopsiapt_PT
dc.subjectCerebro/patologiapt_PT
dc.subjectEncefalopatiaspt_PT
dc.subjectBiopsypt_PT
dc.subjectBrain/pathologypt_PT
dc.subjectBrain Diseasespt_PT
dc.titleImpact of brain biopsy on management of nonneoplastic brain diseasept_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.startPage100863pt_PT
oaire.citation.titleBrain and Spinept_PT
oaire.citation.volume2pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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