Brain Tumor Surgery

Listed below is the step by step procedure of brain tumour surgery:

  1. What is Brain Tumor Surgery ?
  2. Why is Brain Tumor Surgery Required?
  3. Pre-operative Preparation
  4. Surgery
  5. Procedure Day
  6. Methods/Techniques of Brain Tumor Surgery
  7. Post Procedure
  8. Risks and Complications

What is Brain Tumor Surgery?

Brain tumor surgery is an operative treatment method performed for removing tumor present in any part of the brain. It serves as the best treatment method to discard benign (non-cancerous) and malignant (cancerous) tumors without causing any neurological impairment.

Why is Brain Tumor Surgery Required?

A brain tumor surgery can be indicated in any of the following conditions:

  • When medication, chemotherapy or radiotherapy fail to provide any relief.
  • To eliminate tumors from your brain that may further cause any other complications or, to prevent it from radiotherapy and chemotherapy
  • To serve as a palliative mode of treatment for conditions like seizures caused due to brain tumors.
  • To collect brain tissue samples for pathological studies. The samples can be studies to provide further diagnosis.

Pre-Operative Procedure

Before undergoing a brain tumor surgery, it is very important for your doctor to first diagnose certain aspects about your brain tumor. Location of the tumor, type of tumor, extent and size of tumor, number of tumors etc., needs to be known before performing a surgery. Your neurosurgeon would require all these details to select and perform the correct method for your brain tumor condition.

In order to get all these details following procedures are performed:

  • Neurological Examination

    Based on what symptoms you are experiencing and your other medical reports and family history, you doctor will conduct a neurological examination. The aim of this exam is confirm about brain tumor and its location. It also provides information about other complications developing in your brain because of the existing tumor. A neurological exam consists of various tests to learn about your hearing, reflexes, vision, and other sensory functions as well as thinking, balance, coordination, ability to remember and store information, etc. Basically, all the functions of the brain are checked in a neurological exam.

    A neurological exam consists of various tests to learn about your hearing, reflexes, vision, and other sensory functions as well as thinking, balance, coordination, ability to remember and store information, etc. Basically, all the functions of the brain are checked in a neurological exam.

  • Brain Scan Tests

    Some of the common scanning techniques used for a brain scan are as follows:

    1. Angiogram
      This test involves injecting a dye into the body which is absorbed by the blood vessels of brain. Any abnormal changes in the brain can be studied.

    2. Computer Tomography (CT) Scan Test
      CT scan is an X-Ray scan done from various angles to create multiple images of the organ to be studied. These images can be studied to learn about brain tumor and other abnormal changes present in your brain.

    3. Functional Magnetic Resonance Imaging (fMRI) Test
      FMRI is a test limited to specific function of your brain. Part by part analysis of brain can be done and the exact location of brain tumor can be found out.

    4. Magnetic Resonance Spectroscopy (MRS)
      Magnetic Resonance Spectroscopy is used to calculate the amount of biochemical changes occurring within your brain. Presence of tumors can be easily detected through this test. It is useful in determining the location of the tumor present within your brain.

    5. Positron Emission Tomography (PET) Scan
      PET scan detects changes within cells as they develop. It involves injecting a radioactive substance into the veins of your brain. This substance is easily absorbed if a tumor is present. It shows how large is the tumor and also its extent.

    6. Tissue Biopsy Test
      A tissue biopsy test involves collecting small tissue samples from the site of your tumor to monitor it under a microscope.

Day Before Brain Tumor Surgery

The procedures and tests carried out on the day before surgery includes all the mandatory tests and measures.

  1. Blood Tests
    Blood tests are carried out to determine the patient's blood group, RBC, WBC, haemoglobin count, etc. All test results should be normal prior to performing the surgery.

  2. Chest X-ray
    Chest X-ray is useful for assessing lung function. Lungs should be healthy to bear the pressure associated with surgery.

  3. Electrocardiogram (ECG)
    An ECG measures the functioning and working of your heart. It is important to check for heart functions before surgery.

  4. Physical Examination
    A physical examination is conducted in order to check any other anomalies present. Discuss about your medical history with your doctor. Let your doctor know if you have any kind of allergy or disorder. Along with the above tests your health care provider will also educate you about other important instructions you should follow on the day of your brain tumor surgery. Such instructions include the following:

    • What type of food you must consume before surgery or it is necessary to come empty stomach on the surgery day?
    • How long you are required to fast?
    • Whether water intake is allowed or should be avoided?
    • Which type of medicines are allowed to take before surgery?
    • Schedule for the surgery day

Also, your surgeon will provide you all the details about brain tumor surgery, its procedure, risks and complications and related details. To approve, you are asked to sign a consent form.

Procedure Day

You are expected to be on time on the day of your brain tumor surgery. You will be asked to lie down on the surgical bed. Before the surgery begins, the team of doctors will make necessary arrangements for your surgery. An intravenous (IV) line will be attached to your arm. Your body will be injected with general anesthesia. Anesthesia relaxes your body and puts you sleep. As soon as the influence of anesthesia starts, doctors will place additional IVs and catheters at required locations of your body. Important fluids will be passed into your body through these IV lines via catheter. Catheter is also used to collect blood samples and drain out other harmful substance from your body.

After making all these necessary arrangements, your team of neurosurgeons will begin with your brain tumor surgery. There are many methods and techniques of performing a brain tumor surgery. Every approach depends on various factors of your brain tumor.

Methods/Techniques of Brain Tumor Surgery

There are many approaches to conduct a brain tumor surgery. Your neurosurgeon picks the best effective method for you based on your condition.

  1. Craniotomy

    This is an initial part of your brain tumor surgery that serves to give assess to your brain. It is a surgical technique that involves removing a flap of the bone from your skull to get access to your brain. Your surgeons use special surgical instruments to cut off a section of your skull. However, this is just a temporary removal. Once the entire brain tumor surgery is performed, this flap is fixed backed at its required place. There are various types of craniotomy procedure that can be used according to your surgical requirements. These types include:

    • Extended Bifrontal Craniotomy
      An extended bifrontal craniotomy is a surgical method used to collect a part of your bone from your head, present behind your hairline between forehead and the contour of the orbits. After locating the tumor, it is removed and the skull bone is then fitted back on its place.

    • Supra-orbital Craniotomy
      A supra-orbital craniotomy is also known as eyebrow craniotomy. It is a minimal invasive approach. Here, your neurosurgeon makes a cut on your eyebrows to get access to the tumors present on the front section of your brain or near your pituitary gland.

    • Retro-sigmoid Craniotomy
      It is a minimal invasive approach that is used to remove tumors present at the base of your skull. It involves making a small, key-hole sized incision behind your ear to get an access to the cerebellum and brainstem region.

    • Orbitozygomatic Craniotomy
      An orbitozygomatic craniotomy is an old approach used to get access to complex tumors. The skull bone between the contour of the orbits and cheeks is removed in this procedure. This technique is used to reduce the amount of damage to the brain caused to brain tumor surgery.

    • Translabyrinthine Craniotomy
      This method involves cutting the scalp behind your ear to remove the mastoid bone and some internal bony structures of your ear. In such a way, your surgeon finds the brain tumor and removes it. The bone parts removed are then fixed back at place.

  2. MRI-guided Laser Ablation

    MRI-guided laser ablation is one of the neurosurgical procedure used to eliminate brain tumors. It utilizes minimal invasive approach. Tiny incisions are made on your scalp around your tumor's site. A surgical instrument is guided through one of these incisions using MRI. Laser beams are passed through the instruments to locate and destroy tumors present within your brain.

  3. Endonasal Endoscopic Surgery

    In an endonasal endoscopic surgery, your surgeon inserts an endoscope through your nasal passageways to operate the frontal part of your brain or the top areas of your spine. A computer screen outputs and displays the images of the inside of the brain which helps the doctor to guide the instruments within and remove the brain tumor.

  4. Neuroendoscopy

    A neuroendoscopy is a neurosurgical process which uses a minimal invasive approach for removal of brain tumor. In this technique, your neurosurgeon directs an endoscope through a small hole through your mouth or nose to reach your tumor's site. There are forceps attached to the endoscope that is used to cut off the tumor and eliminate it. This technique involves removal of brain tumors without causing any harm to other parts of your brain and skull.

Post Procedure

After every type of surgery, you must take proper care of your body in the post procedure phase so that you completely recover from the disorder you are facing. Brain tumor surgery requires a lot of care and rest after the main procedure is finished. It disturbs your thought process, behavior and feelings. These brain functions can be a little more problematic for some initial days until you completely recover. Also, aged people may take longer to recover.

  • Recovery at the Hospital

    After successfully performing your brain tumor surgery, nurses will suture all the desires cuts of the inside and outside of your brain. Wounds will be covered in septic bandages. A cotton dressing will be made over your head to avoid bleeding and hold your bandages in place.

    During the early days of post surgery period, neurologists and nurses will constantly monitor you brain.

    Your doctor will give you a list of instructions that you are supposed to follow during your recovery period.

  • Recovery at Home

    You will experience many changes in your thinking, behavior, understanding and many other functions that your brain performs. Also, some functions may get slower that regular time after your surgery. This can create many confusion among you. Therefore, for initial few day post brain tumor surgery, you need to take it easy and just rest well.

    As you recover day by day your doctor will tell you when you are ready to perform certain activities. Until then, follow all the instructions your doctor has told you to carry out. Take all your medications on time. Maintain the schedules of medications and diet as per suggested by your neurologist. Follow an energy-rich balanced diet to keep your body fit and healthy. Maintain hygiene during this period to keep your body away from any infections or disorders.

    Inform your doctors right away if you are facing any other abnormal conditions. Patients may experience seizures during their healing and recovery phase. Also, apart from these important measures, take proper precautions as well. Go for follow-up sessions and physical therapy sessions as per scheduled. Sometimes psychological therapy sessions are carried out to for better recovery.

Risks and Complications

Some potential risks are likely to occur after a brain tumor surgery. Some of the common risks and complications after a brain tumor surgery include:

  • Bleeding
  • Fever
  • Pneumonia
  • Unstable Blood Pressure
  • Blood Clots
  • Infections

The above information covers all the concepts of brain tumor surgery. You must know which health condition calls for this surgery. Also, all the preoperative procedures, main procedures and post procedures are mention along with it. Our brain helps to coordinate and maintain balance in our body. If any deformities occur within your brain should be fixed well before it becomes lethal for your health condition.

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