Brain Biopsy
Norm of Brain Biopsy
Normal tissue.
Usage of Brain Biopsy
Confirmation of Alzheimer's disease, cerebral amyloid angiopathy, cerebral blastomycosis, cerebral Whipple's disease, Creutzfeldt-Jakob disease, encephalitis, granulomatous angiitis, HIV complications, identification and classification of tumors of the brain or metastasis to the brain, neuronal ceroid lipofuscinosis.
Description of Brain Biopsy
Specimens of brain tissue are obtained during a craniotomy and sent to the pathology laboratory. The electron microscope is used to identify and classify tumors for more accurate diagnosis, on which proper therapy and prognosis depend. The pathologist may also examine the specimen for antigen localization, which identifies the cell of origin of the antigen. This identifies the origin of metastatic carcinoma.
Professional Considerations of Brain Biopsy
Consent form IS required for the procedure used to obtain the biopsy sample.
Risks
Blindness, cerebrovascular accident, headache, hemorrhage (silent after stereotactic brain biopsy), infection, meningitis, paralysis.
Contraindications
Anticoagulant therapy, bleeding disorders, increased intracranial pressure.
Preparation
- Obtain a specimen container.
- Arrange for immediate handling of the specimen in the pathology department.
- Just before beginning the procedure, take a “time out” to verify the correct client, procedure, and site.
Procedure
- A fresh specimen of brain tissue is placed into a plastic container with saline-moistened, sterile gauze and given to the pathologist, who is in the operating room or waiting in the laboratory for the immediate delivery of the specimen.
- If immediate preparation of the specimen by the pathologist is not possible, the specimen is immediately cut into 1-mm cubes and placed into a vial of 2%–4% phosphate, cacodylate-buffered glutaraldehyde, paraformaldehyde, or other fixative, according to the policy of the institution.
Postprocedure Care
- Tailor care to the procedure used to gain access to the brain tissue.
Client and Family Teaching
- Results are normally available within 24 hours.
Factors That Affect Results
- The specimen must be fresh.
- Placing the specimen in formalin or in the wrong fixative or taking more than 2–3 minutes to place it in the fixative after collection invalidates the results.
- If antigen localization is done, the antisera must be available.
Other Data
- Brain scans are usually performed before surgery to assist in specific localization of the tumor for biopsy.
