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Stereotactic brainstem biopsy in a patient with coagulopathy of unclear etiology: case report.

C Beynon, T Hoffmann, W Wick, A W Unterberg, K L Kiening
Minimally Invasive Neurosurgery : MIN 2011 October
BACKGROUND: Parenchymal hemorrhage is one of the most feared risks of stereotactic brain biopsies potentially resulting in neurological deficits or even a fatal outcome. Patients with disorders of the coagulation system are at particular risk, so identifying these is one of the main tasks prior to surgery. Some patients may have a bleeding tendency despite normal laboratory values of the hemostatic system.

CASE REPORT: We report the case of a patient with coagulopathy of unclear etiology undergoing a stereotactic brainstem biopsy.

CONCLUSION: A medication scheme with tranexamic acid and desmopressin effectively decreased the patient's bleeding time in vivo and the procedure was carried out without complications.

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