neurosurgeons performing brain tumor surgery

Brain Tumor Surgery – What Do They Do?

Introduction

Brain tumor surgery is a broad term that encompasses all the procedures that are undertaken in an attempt to repair a structural issue inside the brain cavity.

Brain surgery becomes inevitable especially in cases that cause symptoms in the patient.

These physical abnormalities can be caused by defects at birth, a disease or an injury by trauma or accident.

Aneurysms, blood clots, abscesses, skull fractures, and tumors are some of the reasons brain surgery is decided as the definite treatment procedure.

Therefore, with respect to the disease under treatment, the type of brain surgical procedure that could be carried out is decided. With recent advances, minimally invasive brain surgery procedures have also been instituted.

Minimally invasive surgeries have substantially reduced the risks that were previously associated with the open procedure.

The common procedures that are carried out in the brain tumor surgery have also been discussed below.

Types of Brain Tumor Surgery procedures 

For an actual understanding of what the surgeons do while performing different types of brain tumor surgeries for different pathologies, the multiple procedures carried out have been individually discussed underneath.

The management plan is drawn out based on the multiple factors influencing the outcome.

The type of ailment, the safety of the patient and the success rates are all put on the table before deciding the type of procedure to be carried out.

Although minimally invasive procedures are favored these days, there are still multiple causes that limit its use. 

A procedure that treats the damage maximally, causes the least damage to the unaffected parts, has the best success rate and does not pose any risk to the life of the patient is the one that is chosen.

The different types that could be used are briefly discussed below:

Biopsy

In this procedure, a small amount of tissue from the brain is taken out to be studied for gross as well as microscopic abnormalities such as tumors.

A biopsy helps determine the type of tumor that has formed. This aids in the further planning of managing the ailment.

This is an important diagnostic procedure that is very commonly carried out to diagnose the abnormality causing disease of the brain. 

Craniotomy

A craniotomy is also called open brain surgery. In this procedure, a special type of drilling machine is used and a cut is made in the cranial cavity or the scalp bone.

A breach in the cavity is formed that exposes the brain floating underneath.

The bone flap is displaced at the diseased site and the intended abnormality is addressed.

This is the most common surgical procedure to be performed. Procedures for treating aneurysms or fluid draining are carried out using this method.

The flap is then secured back on the scalp through screws and plates. 

Neuroendoscopy

Some brain surgeries are also possible by creating a small hole through the skull and passing an endoscope through it in order to carry out the desired task.

This procedure is also called a minimally invasive procedure since a small portion of the organ is exposed in order to address the abnormality.

This surgery is done especially for tumors where after a small hole is drilled, the tumor is removed endoscopically without unnecessarily exposing the brain tissue and limiting the risk of infection or trauma.

Deep Brain Stimulation

In this type of procedure, electrodes are placed within the brain and the nerves are stimulated by electrical signals across electrodes.

These electrical signals are employed in the treatment of the disease-causing pathology in the central nervous system.

Neurodegenerative disorders like Parkinson’s disease, tumors or epilepsy diseases are all treated using this procedure of brain stimulation around the brain tissue by controlled electrical signaling.

Endonasal endoscopic surgery

As the name suggests, a thin tube is passed through the nasal cavity directly to the front of the brain.

This surgical procedure is specially carried out to treat the tumors or abnormalities in the frontal areas of the brain that can be easily reached by the endoscope passed through the nose.

This is also a type of minimally invasive surgery.

Awake brain surgery

As the name suggests, this type of open brain tumor surgery is carried out while the patient is under local anesthesia and is wide awake and responding.

This type of procedure allows the surgeons to note the responses of the patient while he skilfully stimulates certain areas of the brain.

The doctor checks speech, vision, memory and motor function while the surgery is being carried out and checks to make sure these functions remain intact.

This delicate procedure is performed especially when those areas of the brain are involved in pathology which is associated with specialized functions of movement, speech, and vision.

The surgeon ensures that only unhealthy tissues are removed. Conditions such as tumors or epilepsies are treated by carrying out this procedure. A patient has even played the violin during awake surgery.

tumor surgery surgical microscope

The Danger Of Brain Tumor Surgery?

Brain surgery is an extremely intricate affair. Areas as small as the size of a pea are associated with critical functions inside the rest of the body.

One of the five major organs being involved, the brain, its surgery becomes a highly elaborative procedure that is woven with risks and dangers.

Although the surgery is carried out by highly specialized neurosurgeons who are trained to carry out a procedure with remarkable precision and avoid damaging the areas of important and complex functions like language and mobility, there are always risks involved.

There is a range of risks that the patient is exposed to:

  • bleeding inside the brain region
  • Fluid build up causing swelling 
  • clot formation and blockage of blood vessels
  • Infection after the surgery like meningitis 
  • Short-term or long-term memory losses called amnesia
  • Allergic reaction to anesthesia 
  • Permanent nerve damage
  • coma or vegetative state 
  • Death

Post-operatively the patient may complain of altered functions like difficulty in speech, balance, change in vision and even impaired coordination.

This is the biggest concern to the doctors while removing damaged parts of the brain during surgery therefore they only remove as much tissue as safely possible.

Swelling of the brain as a result of fluid accumulation is still a major worry after the surgery which is dangerous and is always likely to increase hospital stay. This majorly slows down the recovery of the patients.

All these risks involved in the surgery of one of the most important organs inside the human body makes the surgery dangerous and challenging for the doctors.

Chance Of Surviving Brain Tumor Surgery?

Survival after brain tumor surgery depends upon several factors. Some of the factors that affect the chances of survival are: 

  • The severity of damage caused by the disease that had to be corrected during the surgery 
  • Age of the patient 
  • The general health of the patient under surgery including other diseases the patient might be suffering from 
  • Complications that may have occurred during or after the surgical procedure 

Above mentioned are some of the factors that predict the chances of surviving brain tumor surgery.

On average the chances of survival for the long term after brain surgery are between 50% and 70% except in cases of malignant tumors where the chances are lowered further.

With the increasing advances in neurosurgical techniques and skills, the surgeons today are more able to carry out a successful surgery and prevent any complications that previously used to lead to an early death.

Based on the data generally collected, younger patients tend to have a better survival rate than those patients who develop brain abnormalities later in life, also patients who have low-grade tumors tend to live a longer life than the ones with a higher grade of malignancies.

Brain Tumor Surgery Recovery Time

Recovery from brain tumor surgery is a time-consuming process that takes about 4 weeks and sometimes more. Full recovery takes about 2 months.

The management team that carries out the surgery is the one that comes up with a recovery plan in order to minimize the possibility of complications that may arise and maximize the functioning ability of the brain after surgery.

The recovery is aimed at improving the quality of life and is always worth the patience post-operatively. 

The plan constitutes regular monitoring during the initial days in the hospital which depends on the type of procedure performed as well as the continued assessment after discharge.

In some cases, physiotherapy or speech therapy are also incorporated in the recovery process to help with the rehabilitation after surgery.

These rehabilitation programs are especially important in cases where a major life or lifestyle change can be seen after the surgical procedure.

Therefore, it is usually the type of procedure carried out, the complications that have occurred, and the overall health of the patient postoperatively that are used to predict how long the recovery will actually take. 

Even after maximum recovery, there are symptoms of damage that could take months before they appear as new symptoms, it is because of this reason that the patient is always advised to keep visiting the doctor frequently and do not miss the follow-up appointments usually given 10 to 14 days after discharge. 

How Long Will I Be In The Hospital After Brain Tumor Surgery?

After brain surgery, you are kept under observation and any immediate or late complications that arise are instantly dealt with.

tumor patient photo

The vital signs of the patient are kept under a constant watch. The patient will be seated in a raised position to prevent any brain swelling from occurring.

You will also be monitored to ensure every brain function is performed appropriately and no unforeseen brain damage has occurred before you can be discharged.

Since the recovery primarily depends on the type of procedure that has been undertaken, the length of hospital stay is also determined by how quickly the patient is stabilized without any complications, how early the patient has regained mobility and can eventually be sent home. 

A typical hospital stay after brain surgery is up to a week or sometimes more. In the case of minimally invasive surgeries, the patient might even be hospitalized for 2-3 days after the procedure. 

Conclusion

Brain surgery is an extremely critical procedure. There are multiple approaches involved in brain surgery which are planned in accordance with the site of damage, amount of damaged tissue and the safety of the patient.

The pros and cons are weighed before a final decision is made. Like other invasive procedures carried out on the human body, there are numerous risks and complications involved that occur during or months after the procedure.

These complications and postoperative risks of the patient not only determine how long the patient will stay at the hospital but also predict the length of time the patient will require in order to reach maximum recovery.

The factors which influence the outcome of the procedure have also been mentioned above. The right amount of attention, care, and assessment of the patient on a regular basis are all necessary for a positive outcome.

The patient is required to closely follow the instructions of the doctor about lifestyle in order to make sure that the complications and recovery time are minimized and the patient goes back to living a normal life as early as possible. 

References:

https://www.cancer.org/cancer/brain-spinal-cord-tumors-adults/about/types-of-brain-tumors.html

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