Total Procedures: 2

Brain Tumor Surgery

Surgery is the primary treatment for brain tumors that can be removed without causing severe damage. Many benign (non-cancerous) tumors are treated only by surgery. Most malignant (cancerous) tumors, however, require treatment in addition to the surgery, such as radiation therapy and/or chemotherapy.

The goals of surgical treatment for brain tumors are multiple and may include one or more of the following:
  • Confirm diagnosis by obtaining tissue that is examined under a microscope.
  • Remove all or as much of the tumor as possible.
  • Reduce symptoms and improve quality of life by relieving intracranial pressure caused by the cancer.
  • Provide access for implantation of internal chemotherapy or radiation.
  • Provide access for delivering intra-surgical treatments, including hypertherapy or laser surgery.

Types of Surgery for Brain Tumors

  • Biopsy - biopsy is a surgical procedure to remove a small piece of tumor in order to confirm the diagnosis. The sample is examined under the microscope by a pathologist who determines the type of the tumor. A biopsy can be performed as part of the surgery to remove the tumor or as a separate procedure.
  • Craniotomy - The most commonly performed surgery for removal of a brain tumor is called a craniotomy. “Crani” means skull, “otomy” means cutting into. In preparation for a craniotomy, a portion of the scalp is usually shaved, and an incision is made through the skin. Using specialized equipment, a surgeon removes a piece of bone to expose the area of the brain over the tumor. The dura mater (the outermost layer of the brain tissue) is opened, the tumor is located and then removed (resected). After the tumor is removed, the bone is usually replaced and the scalp stitched shut.
  • Shunt - Some patients with brain tumors develop increased intracranial pressure. To relieve the pressure, a procedure is conducted to drain excess or blocked fluid. A shunt is a narrow piece of flexible tubing (called a catheter) that is inserted into a ventricle in the brain. The other end of the tubing is threaded under the scalp toward the neck, then, still under the skin, threaded to another body cavity where the fluid is drained and absorbed. The body cavities used for drainage are the right atrium of the heart and, more commonly, the abdominal cavity. Compared to other surgical treatments for brain tumors, the procedure to implant a shunt is relatively minor. A small hole is drilled in the skull through which the catheter is threaded into a ventricle. A small incision is made in the abdomen or the chest, depending on which cavity is used for drainage. The other end of the catheter is threaded under the skin to the cavity and then fastened

Healing time

After brain surgery, as with any type of surgery, it will take time to recover. Recovery is different for everyone and depends on:
  • The location of the tumor within the brain
  • Areas of the brain affected by the surgery
  • The patient’s age and overall health

Craniotomy

Craniotomy is an operation where a disc of bone is removed from the skull using special tools to allow access to the underlying brain.

A craniotomy involves making an incision in the scalp and removing a window of bone from the skull (this bone is secured back in position at the end of the operation). This allows access to the inside of the skull and brain, and the tumour is either biopsied (a small piece taken to be sent to the pathologist), or excised (removed).

Craniotomy - Procedure

  • The hair on the scalp is shaved.
  • Patient is given a general anaesthetic.
  • The head is placed on a round or horseshoe-shaped headrest so that the area where the brain injury is thought to lie is easily accessible. If head movement must be minimised, head is clamped into place with a head pin fixing device.
  • Through preoperative imaging, the neurosurgeon determines the most appropriate site for the craniotomy. The procedure begins by first cutting through the scalp.
  • Small holes (burr holes) are drilled into the exposed skull with an instrument called a perforator.
  • An instrument called a craniotome is used to cut from one burr hole to the next, creating a removable bone flap.
  • The membrane covering the brain is opened, usually as a flap.
  • The brain injury or disease is operated on – for example, ruptured blood vessels are repaired, or the blood clot or tumour is removed.
  • After the operation is finished, the piece of excised bone is replaced, the muscle and skin are stitched up and a drain is placed inside the brain to remove any excess blood left from the surgery.
  • A craniotomy can take about two and a half hours.

Healing time

Patient is expected to stay in hospital for between five days and two weeks. The length of stay depends on many factors, such as the type of surgery you had and whether or not patient experienced complications or required further operations. Stitches (or staples) are usually removed about one week after surgery.Ptient may experience headaches for about two weeks.Walking is a recommended form of exercise. Patient should wait at least three months before they return to gentle, non-contact sporting activities. Contact sports should be avoided for at least one year.Physiotherapy, occupational therapy and speech therapy can help to manage any neurological problems like clumsiness and speech problems. Usually, therapy is only needed if there were neurological problems before surgery.