{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T02:55:49Z","timestamp":1776740149319,"version":"3.51.2"},"reference-count":50,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background: <\/jats:title>\n<jats:p>The present study presents our experience with computed tomography (CT)-guided stereotactic surgery in managing deep-seated brain lesions and provides a background in the expanding fields of morphological stereotactic neurosurgery.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Methods: <\/jats:title>\n<jats:p>We conducted this retrospective cohort study on 80 patients managed at the Department of Neurosurgery, Zagazig University Hospitals, Zagazig, Egypt, between January 2019 to January 2021. We targeted patients with morphological stereotactic surgeries performed as the primary management modality of their treatment.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Results: <\/jats:title>\n<jats:p>A total of 80 patients, with a mean age of 44.3 years, were included in the study. The stereotactic targets were supratentorial in 71 patients (88.75%), infratentorial in seven patients (8.75%), and both supraand infratentorial in two patients (2.5%). The lesions showed enhancements with IV contrast in 55 patients (68.75%). Stereotactic procedures were performed under local anesthesia in 64 patients and general anesthesia in 16 patients. Of the 80 stereotactic procedures, 52 were biopsies (65%). We observed a significant improvement in the postoperative Karnofsky performance score compared to the postoperative score (63.4 \u00b1 19.8 vs. 56.7 \u00b1 15.4, <jats:italic>P<\/jats:italic> = 0.001). The level of agreement between clinical, radiological, and final pathological diagnosis was assessed; it was complete in 47.5% of the patients. The postprocedural CT scan demonstrated intracranial hemorrhage in five patients (6.25%); four (5%) were silent with no neurological complications.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st4\">\n<jats:title>Conclusion: <\/jats:title>\n<jats:p>This study provided evidence that the stereotactic procedure is easy to perform, accurate in targeting the lesion, and spares patients from undergoing major surgical procedures. Stereotactic applications of spontaneous intracerebral hemorrhage, deep-seated abscesses, encysted tumors, or medically refractory benign intracranial hypertension can improve the outcome even in medically high-risk patients.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_1131_2022","type":"journal-article","created":{"date-parts":[[2023,5,29]],"date-time":"2023-05-29T11:40:40Z","timestamp":1685360440000},"page":"184","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Computed tomography-guided stereotactic surgery in the management of brain lesions: A single-center experience"],"prefix":"10.25259","volume":"14","author":[{"given":"Mohamed","family":"Salah","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Zagazig University, Zagazig, Egypt."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed","family":"Shalaby","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Zagazig University, Zagazig, Egypt."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2023,5,26]]},"reference":[{"key":"10.25259\/SNI_1131_2022\/ref-1","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1111\/j.1440-1789.2005.00634.x","article-title":"Accuracy and diagnostic yield of stereotactic biopsy in the diagnosis of brain masses: Comparison of results of biopsy and resected surgical specimens","volume":"25","author":"Aker","year":"2005","journal-title":"Neuropathology"},{"key":"10.25259\/SNI_1131_2022\/ref-2","doi-asserted-by":"crossref","first-page":"565","DOI":"10.3171\/jns.2005.102.3.0565","article-title":"A contralateral, transfrontal, extraventricular approach to stereotactic brainstem biopsy procedures","volume":"102","author":"Amundson","year":"2005","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_1131_2022\/ref-3","doi-asserted-by":"crossref","first-page":"170","DOI":"10.4103\/0976-9668.127319","article-title":"Tuberculous brain abscess in an immunocompetent adolescent","volume":"5","author":"Ansari","year":"2014","journal-title":"J Nat Sci Biol Med"},{"key":"10.25259\/SNI_1131_2022\/ref-4","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1007\/BF02303807","article-title":"Importance of image-guided stereotactic biopsy to confirm diagnosis in an oncological setting","volume":"1","author":"Arbit","year":"1994","journal-title":"Ann Surg Oncol"},{"key":"10.25259\/SNI_1131_2022\/ref-5","doi-asserted-by":"crossref","first-page":"367","DOI":"10.3174\/ajnr.A1362","article-title":"Distinguishing recurrent intra-axial metastatic tumor from radiation necrosis following gamma knife radiosurgery using dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging","volume":"30","author":"Barajas","year":"2009","journal-title":"Am J Neuroradiol"},{"key":"10.25259\/SNI_1131_2022\/ref-6","doi-asserted-by":"crossref","first-page":"354","DOI":"10.3171\/jns.2002.97.2.0354","article-title":"Histological yield, complications, and technological considerations in 114 consecutive frameless stereotactic biopsy procedures aided by open intraoperative magnetic resonance imaging","volume":"97","author":"Bernays","year":"2002","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_1131_2022\/ref-7","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1016\/j.acra.2011.01.018","article-title":"Distinguishing recurrent high-grade gliomas from radiation injury","volume":"18","author":"Bisdas","year":"2011","journal-title":"Acad Radiol"},{"key":"10.25259\/SNI_1131_2022\/ref-8","doi-asserted-by":"crossref","first-page":"649","DOI":"10.3171\/JNS\/2008\/108\/4\/0649","article-title":"Outpatient brain tumor surgery: Innovation in surgical neurooncology","volume":"108","author":"Boulton","year":"2008","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_1131_2022\/ref-9","first-page":"481","article-title":"Frozen section evaluation of stereotactic brain biopsies: Diagnostic yield at the stereotactic target position in 188 cases","volume":"121","author":"Brainard","year":"1997","journal-title":"Arch Pathol Lab Med"},{"key":"10.25259\/SNI_1131_2022\/ref-10","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1007\/BF01418467","article-title":"Treatment of deep brain abscesses by stereotactic implantation of an intracavitary device for evacuation and local application of antibiotics","volume":"76","author":"Broggi","year":"1985","journal-title":"Acta Neurochir (Wien)"},{"key":"10.25259\/SNI_1131_2022\/ref-11","first-page":"17","article-title":"The accuracy and diagnostic yield of computerized tomography guided stereotactic biopsy in brain lesions","volume":"18","author":"\u00c7ali\u015faneller","year":"2008","journal-title":"Turk Neurosurg"},{"key":"10.25259\/SNI_1131_2022\/ref-12","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1016\/S1470-2045(09)70263-3","article-title":"Neurocognition in patients with brain metastases treated with radiosurgery or radiosurgery plus whole-brain irradiation: A randomised controlled trial","volume":"10","author":"Chang","year":"2009","journal-title":"Lancet Oncol"},{"key":"10.25259\/SNI_1131_2022\/ref-13","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1016\/j.ijrobp.2013.05.015","article-title":"Challenges with the diagnosis and treatment of cerebral radiation necrosis","volume":"87","author":"Chao","year":"2013","journal-title":"Int J Radiat Oncol"},{"key":"10.25259\/SNI_1131_2022\/ref-14","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1016\/j.clineuro.2009.08.013","article-title":"Stereotactic brain biopsy: Single center retrospective analysis of complications","volume":"111","author":"Chen","year":"2009","journal-title":"Clin Neurol Neurosurg"},{"key":"10.25259\/SNI_1131_2022\/ref-15","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1016\/0090-3019(84)90003-X","article-title":"Stereotactic exploration of the brain in the era of computed tomography","volume":"22","author":"Dade Lunsford","year":"1984","journal-title":"Surg Neurol"},{"key":"10.25259\/SNI_1131_2022\/ref-16","doi-asserted-by":"crossref","first-page":"1915","DOI":"10.1007\/s00701-010-0752-0","article-title":"Towards improving the safety and diagnostic yield of stereotactic biopsy in a single centre","volume":"152","author":"Dammers","year":"2010","journal-title":"Acta Neurochir (Wien)"},{"key":"10.25259\/SNI_1131_2022\/ref-17","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1148\/radiology.158.1.3940373","article-title":"Brain radiation lesions: MR imaging","volume":"158","author":"Dooms","year":"1986","journal-title":"Radiology"},{"key":"10.25259\/SNI_1131_2022\/ref-18","doi-asserted-by":"crossref","first-page":"S27","DOI":"10.1016\/j.surneu.2005.11.036","article-title":"Stereotactic computed tomography-guided brain biopsy: Diagnostic yield based on a series of 170 patients","volume":"65","author":"Ferreira","year":"2006","journal-title":"Surg Neurol"},{"key":"10.25259\/SNI_1131_2022\/ref-19","first-page":"36","article-title":"Stereotactic biopsy of intracranial brain lesions. High diagnostic yield without increased complications: 65 consecutive biopsies with early postoperative CT scans","volume":"71","author":"Fritsch","year":"1998","journal-title":"Stereotact Funct Neurosurg"},{"key":"10.25259\/SNI_1131_2022\/ref-20","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1227\/01.NEU.0000309602.15208.01","article-title":"The birth of stereotactic surgery: A personal retrospective","volume":"54","author":"Gildenberg","year":"2004","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_1131_2022\/ref-21","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1007\/s00701-005-0495-5","article-title":"Haemorrhagic complications and the incidence of asymptomatic bleeding associated with stereotactic brain biopsies","volume":"147","author":"Grossman","year":"2005","journal-title":"Acta Neurochir (Wien)"},{"key":"10.25259\/SNI_1131_2022\/ref-22","first-page":"1631","article-title":"Management of suppurative intracranial infections. Schmidek and Sweet Operative Neurosurgical Techniques: Indications","volume-title":"Methods, and Results","volume":"2","author":"Grossman","year":"2012","edition":"6th ed"},{"key":"10.25259\/SNI_1131_2022\/ref-23","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1055\/s-2003-40736","article-title":"Stereoscopic navigation-controlled display of preoperative MRI and intraoperative 3D ultrasound in planning and guidance of neurosurgery: New technology for minimally invasive image-guided surgery approaches","volume":"46","author":"Hernes","year":"2003","journal-title":"Minim Invasive Neurosurg"},{"key":"10.25259\/SNI_1131_2022\/ref-24","first-page":"341","article-title":"Computerized tomography-guided stereotactic aspiration of brain abscesses: Experience with 28 cases","volume":"62","author":"Hsieh","year":"1999","journal-title":"Zhonghua Yi Xue Za Zhi (Taipei)"},{"key":"10.25259\/SNI_1131_2022\/ref-25","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1007\/s10014-006-0204-y","article-title":"Correlation of diagnostic yield of stereotactic brain biopsy with number of biopsy bits and site of the lesion","volume":"23","author":"Jain","year":"2006","journal-title":"Brain Tumor Pathol"},{"key":"10.25259\/SNI_1131_2022\/ref-26","doi-asserted-by":"crossref","first-page":"394","DOI":"10.4103\/0028-3886.28113","article-title":"Comparative analysis of diagnostic accuracy of different brain biopsy procedures","volume":"54","author":"Jain","year":"2006","journal-title":"Neurol India"},{"key":"10.25259\/SNI_1131_2022\/ref-27","first-page":"89","article-title":"Brain abscess--modern diagnostics and therapeutic treatment","volume":"63","author":"Kalinowska-Nowak","year":"2009","journal-title":"Przegl Epidemiol"},{"key":"10.25259\/SNI_1131_2022\/ref-28","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/S1042-3680(18)30540-0","article-title":"Pitfalls and problems in the histopathologic evaluation of stereotactic needle biopsy specimens","volume":"5","author":"Kepes","year":"1994","journal-title":"Neurosurg Clin N Am"},{"key":"10.25259\/SNI_1131_2022\/ref-29","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1007\/BF01808553","article-title":"Factors that enhance the likelihood of successful stereotactic treatment of brain abscesses","volume":"127","author":"Kondziolka","year":"1994","journal-title":"Acta Neurochir (Wien)"},{"key":"10.25259\/SNI_1131_2022\/ref-30","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1017\/S0317167100007605","article-title":"Complications in 622 cases of frame-based stereotactic biopsy, a decreasing procedure","volume":"35","author":"Kongkham","year":"2008","journal-title":"Can J Neurol Sci"},{"key":"10.25259\/SNI_1131_2022\/ref-31","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1227\/01.neu.0000316257.21478.5b","article-title":"Stereotactic aspiration and antibiotic treatment combined with hyperbaric oxygen therapy in the management of bacterial brain abscesses","volume":"62","author":"Kutlay","year":"2008","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_1131_2022\/ref-32","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1007\/s11060-009-0073-4","article-title":"The role of stereotactic radiosurgery in the management of patients with newly diagnosed brain metastases: A systematic review and evidence-based clinical practice guideline","volume":"96","author":"Linskey","year":"2010","journal-title":"J Neurooncol"},{"key":"10.25259\/SNI_1131_2022\/ref-33","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1227\/00006123-199501000-00010","article-title":"Improved management of multiple brain abscesses: A combined surgical and medical approach","volume":"36","author":"Mamelak","year":"1995","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_1131_2022\/ref-34","doi-asserted-by":"crossref","first-page":"32","DOI":"10.4103\/0976-3147.127869","article-title":"Stereotactic biopsy of brainstem lesions: Techniques, efficacy, safety, and disease variation between adults and children: A single institutional series and review","volume":"5","author":"Manoj","year":"2014","journal-title":"J Neurosci Rural Pract"},{"key":"10.25259\/SNI_1131_2022\/ref-35","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/S0090-3019(03)00048-X","article-title":"MRI-guided stereotactic biopsy in the diagnosis of glioma: Comparison of biopsy and surgical resection specimen","volume":"59","author":"McGirt","year":"2003","journal-title":"Surg Neurol"},{"key":"10.25259\/SNI_1131_2022\/ref-36","doi-asserted-by":"crossref","first-page":"897","DOI":"10.3171\/jns.2005.102.5.0897","article-title":"Independent predictors of morbidity after image-guided stereotactic brain biopsy: A risk assessment of 270 cases","volume":"102","author":"McGirt","year":"2005","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_1131_2022\/ref-37","doi-asserted-by":"crossref","first-page":"116","DOI":"10.4103\/0976-3147.131648","article-title":"Biopsy of brain stem gliomas: Changing trends?","volume":"5","author":"Mohanty","year":"2014","journal-title":"J Neurosci Rural Pract"},{"key":"10.25259\/SNI_1131_2022\/ref-38","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1017\/S031716710000086X","article-title":"The role of stereotactic cyst aspiration for glial and metastatic brain tumors","volume":"27","author":"Niranjan","year":"2000","journal-title":"Can J Neurol Sci"},{"key":"10.25259\/SNI_1131_2022\/ref-39","doi-asserted-by":"crossref","first-page":"S421","DOI":"10.4103\/2152-7806.140211","article-title":"Diagnostic yield and morbidity by neuronavigation-guided frameless stereotactic biopsy using magnetic resonance imaging and by frame-based computed tomography-guided stereotactic biopsy","volume":"5","author":"Nishihara","year":"2014","journal-title":"Surg Neurol Int"},{"key":"10.25259\/SNI_1131_2022\/ref-40","first-page":"E148","article-title":"Morbidity of stereotactic biopsy for intracranial lesions","volume":"56","author":"Nishihara","year":"2010","journal-title":"Kobe J Med Sci"},{"key":"10.25259\/SNI_1131_2022\/ref-41","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1007\/s11060-009-9871-y","article-title":"Frame-based stereotaxy in a frameless era: Current capabilities, relative role, and the positive-and negative predictive values of blood through the needle","volume":"93","author":"Owen","year":"2009","journal-title":"J Neurooncol"},{"key":"10.25259\/SNI_1131_2022\/ref-42","doi-asserted-by":"crossref","first-page":"11832","DOI":"10.3390\/ijms150711832","article-title":"The diagnosis and treatment of pseudoprogression, radiation necrosis and brain tumor recurrence","volume":"15","author":"Parvez","year":"2014","journal-title":"Int J Mol Sci"},{"key":"10.25259\/SNI_1131_2022\/ref-43","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1212\/WNL.41.2_Part_1.279","article-title":"Percutaneous aspiration of brain tumor cysts via the ommaya reservoir system","volume":"41","author":"Rogers","year":"1991","journal-title":"Neurology"},{"key":"10.25259\/SNI_1131_2022\/ref-44","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1007\/s002340100703","article-title":"Differentiation of radiation necrosis from tumor progression using proton magnetic resonance spectroscopy","volume":"44","author":"Schlemmer","year":"2002","journal-title":"Neuroradiology"},{"key":"10.25259\/SNI_1131_2022\/ref-45","doi-asserted-by":"crossref","first-page":"12318","DOI":"10.18632\/oncotarget.7131","article-title":"Stereotactic radiosurgery (SRS) in the modern management of patients with brain metastases","volume":"7","author":"Soliman","year":"2016","journal-title":"Oncotarget"},{"key":"10.25259\/SNI_1131_2022\/ref-46","first-page":"135","article-title":"Complications and diagnostic yield of stereotactic biopsy for the patients with malignant brain tumors","volume":"32","author":"Takahashi","year":"2004","journal-title":"Neurol Surg"},{"key":"10.25259\/SNI_1131_2022\/ref-47","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1007\/978-3-211-84820-3_33","article-title":"Stereotactic biopsies for tumors: Indications, limits, diagnosis with histopathology and other laboratory techniques","volume-title":"Practical Handbook of Neurosurgery","author":"Thomas","year":"2009"},{"key":"10.25259\/SNI_1131_2022\/ref-48","doi-asserted-by":"crossref","first-page":"233","DOI":"10.3171\/jns.2006.104.2.233","article-title":"Frameless image-guided stereotactic brain biopsy procedure: Diagnostic yield, surgical morbidity, and comparison with the frame-based technique","volume":"104","author":"Woodworth","year":"2006","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_1131_2022\/ref-49","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1179\/016164105X40057","article-title":"Accuracy of frameless and frame-based image-guided stereotactic brain biopsy in the diagnosis of glioma: Comparison of biopsy and open resection specimen","volume":"27","author":"Woodworth","year":"2005","journal-title":"Neurol Res"},{"key":"10.25259\/SNI_1131_2022\/ref-50","doi-asserted-by":"crossref","first-page":"S53","DOI":"10.4103\/2152-7806.91612","article-title":"Pitfalls in precision stereotactic surgery","volume":"3","author":"Zrinzo","year":"2012","journal-title":"Surg Neurol Int"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/computed-tomography-guided-stereotactic-surgery-in-the-management-of-brain-lesions-a-single-center-experience\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/computed-tomography-guided-stereotactic-surgery-in-the-management-of-brain-lesions-a-single-center-experience\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,29]],"date-time":"2023-05-29T11:41:22Z","timestamp":1685360482000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/computed-tomography-guided-stereotactic-surgery-in-the-management-of-brain-lesions-a-single-center-experience\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,26]]},"references-count":50,"alternative-id":["10.25259\/SNI_1131_2022"],"URL":"https:\/\/doi.org\/10.25259\/sni_1131_2022","relation":{},"ISSN":["2152-7806","2229-5097"],"issn-type":[{"value":"2152-7806","type":"electronic"},{"value":"2229-5097","type":"print"}],"subject":[],"published":{"date-parts":[[2023,5,26]]},"article-number":"184"}}