Stereotactic Brain Biopsies in AIDS Patients - Early Local Experience

KK Yeo, TT Yeo, CY Chan, YY Sitoh, J Teo, SY Wong
Correspondence: Dr T T Yeo

ABSTRACT
Aim To assess the usefulness of stereotactic brain biopsies in AIDS patients with cerebral lesions in Singapore.
Methods A total of 10 patients with AIDS and cerebral lesions underwent stereotactic brain biopsies in the Department of Neurosurgery, Tan Tock Seng Hospital (TTSH) between September 1997 and September 1998. The patients were referred from the Communicable Diseases Centre (CDC), TTSH. These patients either failed a trial of therapy for toxoplasmosis encephalitis (TE) or had CT/MRI scans which did not suggest TE. Four were CT-guided and six were MRI-guided stereotactic biopsies. The Radionics Cosman-Robert-Wells (CRW) stereotactic apparatus was used for all cases.
Results The male to female ratio was 9:1. Histological diagnosis from biopsy was lymphoma (5), metastatic adenocarcinoma (1), TE (1), abscess (1), encephalitis (1) and granulomatous tissue (1-presumed tuberculosis).
Conclusion The early experience is that stereotactic brain biopsy is useful in patients with AIDS and cerebral lesions. The etiology is confirmed in the majority of cases and impacts on management decisions and prognostication.

Keywords: stereotactic brain biopsy, HIV, cerebral lesions
Singapore Med J 2000; 41(4): 161-166