Objectives Stereotactic brain biopsy is an established neurosurgical procedure utilised in times of diagnostic or therapeutic uncertainty. Achieving a definitive tissue diagnosis allows tailored surgical, medical or oncological management. We present a 1 year case review of brain biopsies and compare suspected pre-operative diagnosis with final tissue outcome.

Design Retrospective analysis of all brain biopsies performed in 2017 in an adult-only neurosurgical unit.

Subjects All patients undergoing brain biopsy.

Methods Theatre records were retrospectively analysed to identify patients undergoing brain biopsy in 2017. Further information was obtained using electronic patient records and radiology reports.

Results 41 patients underwent brain biopsy in 2017. Only 1 proved inconclusive and required repeat procedure. 26 patients had a suspected diagnosis documented pre-operatively based on radiological/clinical evidence. The most commonly suspected pathologies were low grade and high grade gliomas (9 and 15 patients). Of 25 patients with both a pre-operative differential and subsequent conclusive tissue diagnosis, 10 (40%) were ultimately given diagnoses which did not match the suspected pathology. Significantly, 1 biopsy diagnosed cerebral lymphoma.

Conclusions Brain biopsy is a relatively safe and simple neurosurgical procedure which can reliably provide a definitive tissue diagnosis. We have demonstrated how it remains a crucial component in formally establishing diagnosis prior to determining optimum management plans.