<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2444-054X</journal-id>
<journal-title><![CDATA[Cirugía y cirujanos]]></journal-title>
<abbrev-journal-title><![CDATA[Cir. cir.]]></abbrev-journal-title>
<issn>2444-054X</issn>
<publisher>
<publisher-name><![CDATA[Academia Mexicana de Cirugía A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2444-054X2019000500554</article-id>
<article-id pub-id-type="doi">10.24875/ciru.19000717</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Utilidad y seguridad de la biopsia estereotáctica en lesiones de fosa posterior en pacientes adultos]]></article-title>
<article-title xml:lang="en"><![CDATA[Usefulness and safety from stereotactic biopsy in posterior fossa lesions in adult patients]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Moreno-Jiménez]]></surname>
<given-names><![CDATA[Sergio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martínez-Vaca]]></surname>
<given-names><![CDATA[Néstor]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pérez-Aguilar]]></surname>
<given-names><![CDATA[Bárbara]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gómez-Calva]]></surname>
<given-names><![CDATA[Brenda]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Díaz-Chávez]]></surname>
<given-names><![CDATA[Jorge J.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Mondragón-Soto]]></surname>
<given-names><![CDATA[Michel G.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto Nacional de Neurología y Neurocirugía Unidad de Radiocirugía ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Centro Médico ABC Centro Neurológico ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Centro Médico ABC  ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>10</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>10</month>
<year>2019</year>
</pub-date>
<volume>87</volume>
<numero>5</numero>
<fpage>554</fpage>
<lpage>558</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2444-054X2019000500554&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2444-054X2019000500554&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2444-054X2019000500554&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Antecedentes: La biopsia por estereotaxia ha sido reportada como segura y útil en pediatría. En adultos es más controvertida debido a la mayor diversidad de opciones diagnósticas.  Objetivo: Demostrar su utilidad y seguridad en pacientes adultos con patología de fosa posterior.  Método: En 2006-2014 se operaron 23 pacientes de fosa posterior. Variables: edad, sexo, diagnóstico preoperatorio y posoperatorio, estereotáctico, localización y complicaciones.  Resultados: 52.2% mujeres y 47.8% hombres. La localización fue la región pontomesencefálica en el 43.5%, el cerebelo en el 39.1%, bulbar en el 13% y pineal en el 4.3%. El diagnóstico preoperatorio fue glioma de tallo en el 78.2%, linfoma en el 8.7% y meningioma, metástasis y absceso en el 4.3% cada uno. En el 73.9% se utilizó el sistema Zamorano-Dujovni y en el 26.1% el CRW. El diagnóstico definitivo fue astrocitoma pilocítico en el 17.4%, astrocitoma difuso en el 13%, respuesta inflamatoria en el 13%, astrocitoma anaplásico en el 8.7%, gliosis en el 8.7%, y glioblastoma, tumor neuroectodérmico primitivo, germinoma, pineoctioma y criptococosis en el 4.3% cada uno. En el 17.4% no hubo diagnóstico. El diagnóstico preoperatorio fue concordante en el 43.5%. Hubo un déficit transitorio y un desplazamiento de uno de los pinchos en el 4.3% de los casos. En el 91.4% no hubo complicaciones.  Conclusiones: Es un procedimiento útil, necesario y seguro en pacientes adultos.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Background: Stereotactic biopsy has been reported as a useful and safety procedure in pediatric patients. In adult patients exist more controversy because a greater number of diagnostic options.  Objective: To demonstrate its usefulness and safety in adult patients with posterior fossa pathology.  Method: From 2006-2014, 23 patients were operated from posterior fossa. Variables: age, gender, state, pre- and postoperative diagnosis, stereotactic device, location and complications.  Results: 52.2% females and 47.8% males. The location was ponto-mesencephalic 43.5%, cerebellum 39.1%, bulbar 13% and pineal region 4.3%. The preoperative diagnosis was brainstem glioma 78.2%, lymphoma 8.7%, and meningioma, metastasis and abscess 4.3% each one. In 73.9% Zamorano-Dujovni device was used and in 26.1% the CRW. The definitive diagnosis was pilocytic astrocytoma 17.4%, diffuse astrocytoma 13%, inflammatory response 13%, anaplastic astrocytoma 8.7%, gliosis 8.7%, glioblastoma, neuroectodermic primitive tumor, germinoma, pineocytoma and cryptococcosis 4.3% each one. In 17.4% there was no diagnosis. The preoperative diagnosis was concordant in 43.5%. One transient deficit and one pin displacement 4.3% were present. 91.4% without complications.  Conclusions: It is a useful, necessary and safety procedure in adult patients.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Biopsia]]></kwd>
<kwd lng="es"><![CDATA[Estereotaxia]]></kwd>
<kwd lng="es"><![CDATA[Fosa posterior]]></kwd>
<kwd lng="es"><![CDATA[Seguridad]]></kwd>
<kwd lng="es"><![CDATA[Utilidad]]></kwd>
<kwd lng="en"><![CDATA[Biopsy]]></kwd>
<kwd lng="en"><![CDATA[Stereotaxy]]></kwd>
<kwd lng="en"><![CDATA[Posterior fossa]]></kwd>
<kwd lng="en"><![CDATA[Safety]]></kwd>
<kwd lng="en"><![CDATA[Usefulness]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Massager]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[David]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Goldman]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Pirotte]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Wikler]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Salmon]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Combined magnetic resonance imaging and positron emission tomography guided sterotactic biopsy in brainstem mass lesions:diagnostic yield in a series of 30 patients]]></article-title>
<source><![CDATA[J Neurosurg]]></source>
<year>2000</year>
<volume>93</volume>
<page-range>951-7</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Beynon]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Neuman]]></surname>
<given-names><![CDATA[JO]]></given-names>
</name>
<name>
<surname><![CDATA[Bösel]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Unterberg]]></surname>
<given-names><![CDATA[AW]]></given-names>
</name>
<name>
<surname><![CDATA[Kiening]]></surname>
<given-names><![CDATA[KL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Stereotactic biopsy and drainage of brainstem abscess caused by Listeria monocytogenes]]></article-title>
<source><![CDATA[Neurol Med Chir (Tokyo)]]></source>
<year>2013</year>
<volume>53</volume>
<page-range>263-5</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Goncalves-Ferreira]]></surname>
<given-names><![CDATA[AJ]]></given-names>
</name>
<name>
<surname><![CDATA[Herculano-Carvalho]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Pimentel]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Stereotactic biopsies of focal brainstem lesions]]></article-title>
<source><![CDATA[Surg Neurol]]></source>
<year>2003</year>
<volume>60</volume>
<page-range>311-20</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cage]]></surname>
<given-names><![CDATA[TA]]></given-names>
</name>
<name>
<surname><![CDATA[Samagh]]></surname>
<given-names><![CDATA[SP]]></given-names>
</name>
<name>
<surname><![CDATA[Mueller]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Nicolaides]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Haas-Kogan]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Prados]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Feasability, safety, and indications for surgical biopsy of intrinsic brainstem tumors in children]]></article-title>
<source><![CDATA[Childs Nerv Syst]]></source>
<year>2013</year>
<volume>29</volume>
<page-range>1313-9</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Marcus]]></surname>
<given-names><![CDATA[KJ]]></given-names>
</name>
<name>
<surname><![CDATA[Dutton]]></surname>
<given-names><![CDATA[SC]]></given-names>
</name>
<name>
<surname><![CDATA[Barnes]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Coelman]]></surname>
<given-names><![CDATA[CN]]></given-names>
</name>
<name>
<surname><![CDATA[Pomery]]></surname>
<given-names><![CDATA[SL]]></given-names>
</name>
<name>
<surname><![CDATA[Goumnerova]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A phase I trial of etanidazole and hyperfractionated radiotherapy in children with diffuse brainstem glioma]]></article-title>
<source><![CDATA[Int J Radiat Oncol Biol Phys]]></source>
<year>2003</year>
<volume>55</volume>
<page-range>1182-5</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Samadani]]></surname>
<given-names><![CDATA[U]]></given-names>
</name>
<name>
<surname><![CDATA[Stein]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Moonis]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Sonnad]]></surname>
<given-names><![CDATA[SS]]></given-names>
</name>
<name>
<surname><![CDATA[Bonura]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Judy]]></surname>
<given-names><![CDATA[KD]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Stereotactic biopsy of brain stem masses:decision analysis and literature review]]></article-title>
<source><![CDATA[Surg Neurol]]></source>
<year>2006</year>
<volume>6</volume>
<page-range>484-91</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Albright]]></surname>
<given-names><![CDATA[AL]]></given-names>
</name>
<name>
<surname><![CDATA[Packer]]></surname>
<given-names><![CDATA[RJ]]></given-names>
</name>
<name>
<surname><![CDATA[Zimmerman]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Rorke]]></surname>
<given-names><![CDATA[LB]]></given-names>
</name>
<name>
<surname><![CDATA[Boyett]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Hammond]]></surname>
<given-names><![CDATA[GD]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Magnetic resonance scans should replace biopsies for the diagnosis of diffuse brain steam gliomas]]></article-title>
<source><![CDATA[Neurosurgery]]></source>
<year>1993</year>
<volume>33</volume>
<page-range>1026</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rachinger]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Grau]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Holtmannspötter]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Herms]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Tonn]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
<name>
<surname><![CDATA[Kreth]]></surname>
<given-names><![CDATA[FW]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Serial stereotactic biopsy of brainstem lesions in adults improves diagnostic accuracy compared with MRI only]]></article-title>
<source><![CDATA[J Neurol Neurosurg Psychiatry]]></source>
<year>2009</year>
<volume>80</volume>
<page-range>1134-9</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Neal]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Van]]></surname>
<given-names><![CDATA[Norman AS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Transcerebellar biopsy of posterior fossa lesions using the Leksell Gama Model stereotactic frame]]></article-title>
<source><![CDATA[Neurosurgery]]></source>
<year>1993</year>
<volume>32</volume>
<page-range>1992-8</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Capitanio]]></surname>
<given-names><![CDATA[JF]]></given-names>
</name>
<name>
<surname><![CDATA[Camporesi]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Franzin]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Barzaghi]]></surname>
<given-names><![CDATA[LR]]></given-names>
</name>
<name>
<surname><![CDATA[Picozzi]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Mortini]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Inverted positioning of Leksell frame G for very low posterior fossa and brain stem lesions biopsies]]></article-title>
<source><![CDATA[J Neurosurg Sci]]></source>
<year>2016</year>
<volume>15</volume>
<page-range>1-6</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hamish]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Kickingereder]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Fischer]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Simon]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Ruge]]></surname>
<given-names><![CDATA[MI]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Update on the diagnostic value and safty of stereotactic biopsy for pediatric brainstem tumors:a systemic review and meta-analysis of 735 cases]]></article-title>
<source><![CDATA[JNS Pediatrics]]></source>
<year>2017</year>
<volume>16</volume>
<page-range>1-8</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Manoj]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Arivazhagan]]></surname>
<given-names><![CDATA[DI]]></given-names>
</name>
<name>
<surname><![CDATA[Bhat]]></surname>
<given-names><![CDATA[DI]]></given-names>
</name>
<name>
<surname><![CDATA[Arvinda]]></surname>
<given-names><![CDATA[HR]]></given-names>
</name>
<name>
<surname><![CDATA[Mahadevan]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Santosh]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Stereotactic biopsy of brainstem lesions:techniques, efficacy, safety, and disease variation between adults and children:a single institutional series and review]]></article-title>
<source><![CDATA[Journal of Neurosci Rural Pract]]></source>
<year>2014</year>
<volume>5</volume>
<page-range>32-40</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
