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Brain surgery treatment is conducted to operate out the abnormal cell formation known as tumor in the tissues of brain. The treatment for brain depends on a various factors, which include type, location and size of the tumor as well as the patient’s age and general health. Treatment methods and procedures differ for children and adults. Brain treatment surgery is conducted in the presence of experts from various medical branches such as neurosurgeons, medical oncologists, radiation oncologists, nurses and a dietitian.

Brain surgery treatment includes,

  • Surgery – In the surgery, a neurosurgeon makes an opening in the skull to remove a brain tumor. This procedure is known as a craniotomy. The surgeon attempts to remove the entire tumor. If the tumor cannot be removed completely without damaging vital brain tissue, surgeon may remove as much of the tumor as possible
  • Radiation Therapy – Also called radiotherapy, is a method in which high-powered rays are used to damage cancer cells and stop their growth. It is often used to destroy tumor tissue that cannot be removed with surgery or to kill cancer cells that may remain after surgery
  • Chemotherapy – It is the use of drugs to kill cancer cells. The doctor may use just one drug or a combination usually giving the drugs orally or by injection into a blood vessel or muscle

What Is Brain Surgery?

The term “brain surgery” refers to various medical procedures that involve repairing structural problems in the brain. There are numerous types of brain surgery. The type used is based on the area of the brain and condition being treated. Advances in medical technology have enabled surgeons to operate on portions of the brain without a single incision near the head.

Brain surgery is a critical and complicated process. The type of brain surgery done depends highly on the condition being treated Brain surgery is done to correct physical abnormalities in the brain. This can be due to birth defect, disease, injury, or other problems.

You may need brain surgery if you have any of the following conditions in or around the brain:

  • Abnormal blood vessels
  • An aneurysm
  • Bleeding
  • Blood clots
  • Damage to the protective tissue called the “dura”
  • Epilepsy
  • Abscesses
  • Nerve damage
  • Parkinson’s disease
  • Pressure after injury
  • Skull fracture
  • A stroke
  • Tumors

Types of Brain Surgery

You may have surgery to

  • Diagnose the type of brain tumour you have
  • Remove the whole tumour to try to cure it
  • Remove as much of the tumour as possible to slow its growth and improve symptoms
  • Remove as much of the tumour as possible to help other treatments work better
  • Insert chemotherapy wafers into the tumour

Put in a tube (shunt) to drain fluid from the brain and relieve pressure

Put in a small plastic capsule (an Ommaya reservoir or ventricular access device) under the scalp so that cancer drugs can be injected into it

If a tumour cannot be completely removed, it is often still advisable to have surgery. The surgeon will be able to remove some of the tumour. This is called debulking. Depending  upon on the location and type of tumor there are different types of brain surgery

Brain Tumor Surgery

The aim of the surgery is to remove the tumor as much as possible and also reducing its symptoms so as to improve the quality of life. To remove a brain tumor, a neurosurgeon makes an opening in the skull. This operation is called a craniotomy. Whenever possible, the surgeon attempts to remove the entire tumor. If the tumor cannot be completely removed without damaging vital brain tissue, your doctor may remove as much of the tumor as possible. A large number of non-cancerous (benign) tumors can only be removed by surgery. However, cancerous (malignant) tumor may require additional treatment apart from surgery like chemotherapy or radiation therapy.

Brain Aneurysm Surgery

Brain aneurysm surgery is surgery to correct an aneurysm. This is a weak area in a blood vessel wall that causes the vessel to bulge or balloon out and sometimes burst (rupture). It may cause:

  • Bleeding into the area around the brain (also called a subarachnoid hemorrhage)
  • Bleeding into the brain that forms a collection of blood (hematoma)

There are two common methods used to repair an aneurysm:
Clipping is done during an open craniotomy.
Endovascular repair, most often using a coil or coiling and stenting (mesh tubes), is a less invasive way to treat some aneurysms.

Endoscopic Brain Surgery

This surgery is for the safe treatment of deep seated tumors in the brain and skull base. Colloid cysts are located in a delicate area of the brain and can be life-threatening as they grow. Unlike traditional surgery In Endoscopic surgery the new techniques allows surgeons placement of a small incision on the scalp followed by a small opening in the skull (6 mm) to allow for insertion of the endoscope. ndoscopic instruments are used to remove the colloid cyst in its entirety. Skull base tumors, such as meningiomas and clival chordomas, can be removed by endoscopic assistance through the patient’s nose.

Minimally Invasive Brain Surgery

Minimally Invasive Surgery in Neurosurgery can be used to diagnose and treat neurological conditions such as brain tumours, hydrocephalus (abnormal buildup of fluid in the brain) and movement disorders such as Parkinson’s disease.

Traditional brain surgery requires removing part of the skull to allow access to the brain. In contrast, minimally invasive surgery usually involves making tiny incisions, e.g. 1 or 2 cm holes. Through these incisions, instruments with tiny video cameras are inserted, giving the surgeons an inside view and enabling surgical access to the affected areas of the brain.

Bleeding Brain Surgery

Bleeding in the brain or in the space between the skull and the brain requires surgery. The surgical procedure is performed for relieving the pressure in the skull and for removing the blood that has built up in the brain. Surgery is the only option by which blood clots are removed surrounding the surface of the brain.

Meningioma Brain Surgery

A meningioma is a tumor that arises from a layer of tissue (the meninges) that covers the brain and spine. Meningiomas grow on the surface of the brain (or spinal cord), and therefore push the brain away rather than growing from within it. Most are considered “benign” because they are slow-growing with low potential to spread. Malignant meningiomas are surgically removed whenever possible, while benign meningiomas are removed if they are large and/or causing neurologic problems.

The type of procedure depends on the size and location of the tumor. The surgery for treating meningioma is a very complex procedure. The aim of the surgery is to preserve the neurological function, removing of sufficient tumor so as to relieve pressure on the normal brain tissue and also removal of the entire tumor so that it will never occur again.

Awake Brain Surgery :

  • Awake brain surgery is a type of procedure performed while you’re awake to treat some brain (neurological) conditions, including some brain tumors or epileptic seizures.
  • If your tumor or seizure center (epilepsy focus) is near the parts of your brain that control vision, movement or speech, you may be awake during surgery to respond to your surgeon.
  • Your responses help your surgeon to ensure that he or she treats the precise area of your brain needing surgery. In addition, the procedure lowers the risk of damage to functional areas of your brain.

Brain Surgery Procedures

Brain surgery is an operation to treat problems in the brain and surrounding structures.

Craniotomy

A craniotomy involves an incision into the scalp and creating a hole in the skull, known as a bone flap. The hole and incision are made near the area of the brain being treated.

During open brain surgery, your surgeon may opt to:

  • Remove tumors
  • Clip off an aneurysm
  • Drain blood or fluid from an infection
  • Remove abnormal brain tissue

When the procedure is complete, the bone flap is usually secured in place with plates, sutures, or wires. The hole may be left open in the case of tumors, infection, or brain swelling. When left open, the procedure is known as a craniectomy.

Biopsy

This procedure is used to remove a small amount of brain tissue or a tumor so it can be examined under a microscope. This involves a small incision and hole in the skull.

Minimally Invasive Endonasal Endoscopic Surgery

This type of surgery allows your surgeon to remove tumors or lesions through your nose and sinuses. It allows them to access parts of your brain without making an incision. The procedure involves the use of an endoscope, which is a telescopic device equipped with lights and a camera so the surgeon can see where they’re working. Your doctor can use this for tumors on the pituitary gland, tumors on the base of the skull, and tumors spreading across the brain.

Minimally Invasive Neuroendoscopy

Similar to minimally invasive endonasal endoscopic surgery, neuroendoscopy uses endoscopes to remove brain tumors. Your surgeon may make small, dime-sized holes in the skull to access parts of your brain during this surgery

Mapping

Different brain regions have specific functions. Before performing any surgery on the brain, including surgery for epilepsy, the surgeon wants to understand how the brain areas affected by the seizures and surrounding brain areas function.  Plans for surgery aim to: remove as much of the seizure focus as possible to control seizures; preserve important functions such as speech, understanding, vision, movement, or sensation; and lessen the risk of complications from the surgery.

Brain mapping is a procedure that can help identify the functions of different regions of the brain.

The exact location of various functions differs quite a bit from person to person. The presence of tumors, seizures, or other brain abnormalities may distort the usual location of some functions. General rules may not a apply.

Mapping the brain by stimulating certain brains areas can help create a map for that person. The map tells the doctors just what parts of the brain are responsible for critical functions such as movement, sensation, speech or other functions.

Shunts

A brain shunt is a narrow piece of tubing that is inserted into the brain in the fluid-filled ventricle. The tubing is then passed under the skin into another area of the body, most often into the abdomen. Occasionally, the shunt tubing can be placed into one of the chambers of the heart or the lining of the lungs. The shunt tubing relieves pressure on the brain, a condition known as hydrocephalus, by draining the extra fluid in the brain ventricle(s) to a different area of the body where it can be absorbed more quickly.

Types of Brain Shunts

  • Ventriculo-Peritoneal – The shunt catheter goes from the ventricle in the brain to the abdominal cavity
  • Ventriculo-Pleural – The shunt catheter goes from the ventricle in the brain to the pleural space located outside the lung
  • Ventriculo-Atrial – The shunt catheter goes from the ventricle in the brain into the right atrium cavity of the heart
  • Programmable – These shunts have special valves that can be adjusted to allow more or less fluid to drain
  • Fixed Pressure – These shunts have valves that drain at a set rate, either low, medium, or high
  • The type of brain shunt a patient receives is dependent on their symptoms and specific diagnosis.