Brain is the one organ which controls all our functional activities and is made up of soft spongy tissue which is encased in a protective shell which we call the skull. All our activities for example emotions, thinking, reacting, reading and writing are controlled by the brain. Brain tumors are either benign tumors which do not invade or spread to the adjacent tissue or are malignant ones which are invasive in nature and spread to the other sites in the body as well. Brain tumor surgery is a type of invasive procedure which is performed to either identify the type of brain tumor to aid in further treatment planning or for the removal of the tumor.
Why is a brain tumour surgery indicated ?
Your consulting surgeon may ask you to get evaluated if you are experiencing the below mentioned symptoms.
- Persistent and frequent headaches
- Nausea and vomiting sensation
- Hearing loss
- Loss of vision
- Seizures or jerks in muscles
- Tingling and numbness of hands and feet
- Problem in orientation while walking, talking or difficulty in doing routine activities
It is essential to explain the symptoms and their duration and frequency once you are consulting a specialist. The consulting neurosurgeon will then conduct a complete physical examination guided by adjuncts like CT scan/ MRI scan, spinal tap (a small amount of cerebrospinal fluid is removed for examination) to come to an appropriate diagnosis to decide the best suited treatment plan.
Who performs a brain tumour surgery ?
Brain tumor surgery is performed by a trained neurosurgeon or a team of neurosurgeons who are efficiently trained in various types of surgical approaches.
What is the aim of a brain tumour surgery ?
A brain tumor surgery is aims at;
- Identification of the type of tumor
- To remove a brain tumor
- Remove the maximum portion of the tumor (debulking) and follow it up with radiotherapy and chemotherapy
- To aid in chemotherapy
What are the determining factors in a brain tumour surgery ?
The success of a brain tumor surgery is dependent on ;
- The type of tumor (benign or malignant)
- The grade of the tumor
- The location of the tumor in the brain
What are the types of the brain tumour surgery ?
There are various types of surgical approaches and options to remove a brain tumor. After an appropriate evaluation of your condition the consultant neurosurgeon suggests the best suited treatment. Few of the types of brain tumor surgeries are illustrated as under.
Biopsy: It refers to surgical removal of a part of tissue from the brain to identify if there is any tumor and which category of tumor it is. This is the initial step in diagnosis of a brain tumor by an interventional approach. The procedure is done either as a day care procedure or the consulting doctor might even ask you to stay in the hospital for one or two days.
The procedure involves administration of anaesthesia. The surgeon drills a small hole in the skull at the site where the biopsy needs to be performed. This procedure is also referred to as Burr hole biopsy. A small needle like instrument is then inserted into the brain to remove a piece of tissue from the tumor which is then sent to a pathology laboratory for evaluation. The report of the biopsied tissue helps in identification of the type of tumor and designing a suitable treatment plan.
A modified type of biopsy for brain tumors is called as Guided biopsy which takes the help of a CT or an MRI scan during the procedure. The use of an MRI or a CT scan helps in precisely locating the site of the biopsy. The procedure is indicated mostly in cases of brain tumors which are deep seated and inaccessible. A guided biopsy can be done in two ways :
- Stereotactic Biopsy: Here a fitted head frame is used during CT or MRI scan to exactly locate the site of the tumor.
- Neuronavigation : This procedure uses a computerised system which already has a scan of the brain loaded and saved on it. This computerised system helps the surgeon in locating the precise site for biopsy in the tumor.
Other modifications in a brain tumor biopsy include an open biospy in which the hole drilled into the skull is larger to allow easy access to th tumor. The biospy procedure is rather a low risk procedure and the patients are usually discharged on the same day with an advice to take some medication for pain and steroids to avoid any swelling.
Craniotomy: Craniotomy is one of the most common procedures done for a brain tumor. A part of your skull bone is cut by the operating surgeon to give access to the tumor. This procedure permits the surgen to remove as much of tumor as possible and the procedure is also referred to as debulking of the tumor. If a part of tumor is left behind the same can be treated by either chemotherapy or by radiotherapy.
Modifications or advancemnts in the craniotomy procedure include awake craniotomy where the patient is given only local anesthesia and the patient is kept awake during the procedure. Awake craniotomy helps the surgeon in recieving response from the patient during the surgical procedure to understand if they are able to smoothly perform movements, talk and feel the surgical procedure. This also improves the outcome of the procedure.
Shunts: The brain tumor can sometime restrict the smooth flow of the cerebrospinal fluid (CSF) in the brain which in turn causes the collection of CSF in the brain. The condition is referred to as Hydrocephalus and it increases the pressure inside the brain. Shunting is a procedure to drain away this collected fluid by the use of plastic tubes/shunts/catheters which are placed at the site of fluid collection during the procedure. The fuild can be drained from the brain to either to the stomach or to the chest cavity. In certain cases of large or inaccesible tumors a shunt might be placed permannently in place.
The side effects of shunts include headaches, drowsiness, stiffness of the neck and general feeling of sickness.
Another approach to remove the collected CSF is use of a Ventricular Access Device also called as the VADs. A dome shaped device which is placed under the scalp. Another benefit of VADs is a reservoir which is attached to it and the same is use for administering chemotherapy .
Microsurgery: This procedure utilizes the use of a microscope to aid in guiding the procedure for the appropriate removal of the tumor. The use of a microscope during the procedure helps the surgeon in identifying the tissue during the procedure.
Ultrasonic Aspiration: This type of procedure is based on the principle of functioning of ultrasonic waves wich break the tumor into smaller bits when the sound waves are generated. A small ultrasonic probe is put into the tumor and then sound waves are generated and then the tumor bits are removed with the help of a suction tip. The procedure also uses very less force hence damage to the adjancent brain tissue is minimal. Ultrasonic aspiration can be used as a part of any brain tumor surgery.
Neuroendoscopy: Neuroendoscopy is a specialised procedure which utilizes an long tube like instrument, a camera and an eyepiece. The instrument is inserted in the brain through a small drill in the skull bone. The principle behind this procedure is minimal reduction of the skull bone and the tumor is approached with the long tube also called as the endoscope which helps the surgeon in visualising the exact tumor site and the surgical procedure. The endoscope also has scissor end to cut away the tumor portion. Neuroendoscopy is mainly indicated for the tumors which are located in the fluid filled spaces or ventricles of the brain.
A modification of Neuroendoscopy procedure is used for the removal of pituitary gland tumors via the nasal approach.
Radiosurgery: This is an advanced procedure which is used for administering high dose radiotherapy to patients diagnosed with brain tumor. This does not require any surgical intervention at all during the procedure.
Do you need to take medication after a brain tumour surgery ?
Yes. Most of the patients who undergo a brain tumor surgery are advised to be on medication for pain, to control the swelling or to control seizures.
What are the risks associated with a brain tumour surgery ?
General risks include bleeding, infection, blood clots at the surgical site. Specific side effects of a brain tumor surgery may vary and can lead to seizures, headaches, loss of vision, hearing loss, uncoordination in balance, inflammation of the layers covering the brain, swelling, stroke. The rare complications include coma and death.
What is the recovery period of a brain tumour surgery ?
The recovery time of a brain tumor surgery depends on the type of the procedure performed, the size of the brain tumor, the location of the brain tumor, patients overall/ general health and areas in the brain affected due to surgery.
The main aim or purpose of a brain tumor surgery is to identify the tumor and prevent its progression. Early diagnosis is always considered as a major factor in determining the success of the procedure. Analysis of one’s symptoms and an early visit to a specialist aids in appropriate treatment. The specialist after a thorough examination suggests the most suited type of treatment or the type of brain tumor surgery which needs to be performed. The type of surgical procedure may vary from patient to patient. The brain tumor surgery is occasionally allied with chemotherapy and radiotherapy to achieve the best results. Even though a brain tumor surgery sometimes cannot completely help in removal of the tumor it definitely helps in debulking of the tumor and relieving the symptoms thereby making it easier for the ancillary procedures to be performed to aid in successful treatment of the brain tumor.
How to find and reach neurosurgeons for brain tumour surgery ?
Now you can find and reach neurosurgeons for brain tumour surgery from different hospitals and destinations on a single platform, Hinfoways. You can avail opinions and information from multiple neurosurgeons , cost estimates for brain tumour surgery from different hospitals, compare things and then choose a neurosurgeon or hospital for brain tumour surgery.
Find, reach and choose a neurosurgeon for brain tumour surgery on Hinfoways. Make an informed choice.
Disclaimer: The content provided here is meant for general informational purposes only and hence SHOULD NOT be relied upon as a substitute for sound professional medical advice, care or evaluation by a qualified doctor/physician or other relevantly qualified healthcare provider.
