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What Is A Brain Biopsy?

Medically reviewed by Abhay Sanan, MD, Susan Kerrigan, MD and Marianne Madsen on January 15, 2022

Are you scheduled to undergo a brain biopsy? If so, you may already know a little about the procedure, but chances are you still have some questions. Here’s everything you need to know about a brain biopsy, including why it’s done, what happens in the operating room, potential risks, and how you’ll recover afterwards.


Why is a brain biopsy performed?


A brain biopsy is performed to diagnose potential abnormalities in the brain, such as malignant tumors. During the procedure, a piece of tissue is removed from the brain and examined in a laboratory setting, where a pathologist will determine if it’s cancerous or benign. If the tissue sample comes back positive for cancer, treatments will be considered based on the type of tumor, its size, and other factors that you’ll discuss with your doctor.


Needle biopsy vs. open biopsy


The most common type of brain biopsy is called an open biopsy, where a surgeon directly opens your skull to remove a piece of brain tissue. Another type is called a needle biopsy, which is less invasive and uses a needle for the same purpose. 


What happens before a brain biopsy?


Prior to the procedure, you will meet with your doctor to sign various legal documents and review your medical history. You will then undergo a series of tests to make sure you’re fit for the operation. If you regularly take blood thinners or anti-inflammatory medications, you’ll need to stop taking them a week before the surgery. Your doctor may advise you on dietary recommendations before the surgery as well.


A day before the biopsy, you will undergo an MRI scan to get an image of your skull and brain. The surgeon will need this to determine where to make incisions and how to operate precisely.


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What happens during a brain biopsy?


In the operating room, you will receive anesthesia. The surgeon will have your MRI/CT scan correlated to your brain using a complex computer system.  Once you are unconscious, he will either drill a small hole in your skull and use a needle to extract a piece of brain tissue (needle biopsy) or make a larger hole in your skull to remove the piece of tissue (open biopsy). Both biopsies are fully assisted by the computer system to attempt to find the tumor with the smallest incision.


After extracting the tissue, the surgeon will close up your skull with a titanium plate/screws.


After the biopsy and recovery


After the procedure is complete, you will be moved to a separate room to recover. A healthcare provider will monitor your vital signs while you’re still unconscious. After you wake up, you will be asked a series of questions and perform several tasks to make sure your brain is functioning normally. In most cases, you’ll need to be in the hospital for one night following the operation.


Once discharged from the hospital, a doctor will advise you on how to resume normal life. You may need to take various medications for a while. However, chances are you’ll be able to return to your regular lifestyle within a few weeks.


Risks of a brain biopsy


Both types of brain biopsies can lead to potential complications such as:


  • Stroke: resulting in weakness, numbness, double vision, visual changes, etc.
  • Seizure
  • Infection 
  • Blood clot
  • Brain swelling
  • Hemorrhage 


Needing a brain biopsy can be frightening. Educating yourself on what’s going to happen and why can help. Work closely with your healthcare providers to ensure all your questions are answered both before and after your surgery.


Written by Natan Rosenfeld

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