Brain Surgery

Written by Brian Krans | Published on August 15, 2012
Medically Reviewed by George Krucik, MD

What is Brain Surgery?

The term “brain surgery” refers to various medical procedures that involve repairing structural problems with 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 let surgeons 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. For example, a brain aneurysm is typically repaired using an endoscope, but if it has ruptured, a craniotomy may be used. Surgeons, to be as careful and thorough as possible, treat each surgery on a case-by-case basis.

Why Brain Surgery Is Done

Brain surgery is done to correct physical abnormalities in the brain. This can be due to birth defect, disease, injury, or other problems.

Brain surgery may be necessary if you have any of the following conditions in or around the brain:

  • abnormal blood vessels
  • aneurysm
  • bleeding
  • blood clots
  • damage to protective tissue (dura)
  • epilepsy
  • infections
  • nerve damage
  • Parkinson’s
  • pressure after injury
  • skull fracture
  • stroke
  • tumors

Not all of these conditions require brain surgery, but many may be helped by it, especially if they pose a risk for worse health problems. For example, a brain aneurysm doesn’t require open brain surgery, but if the vessel ruptures, the open surgery may be needed.

Types of Brain Surgery

There are several different types of brain surgery. The type used depends on the problem being treated.

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, or 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 surgeons to remove tumors or lesions through the nose and sinuses. It allows them to access parts of the 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 he or she is working. This is used for tumors on the pituitary gland, base of the skull, and those spreading across the brain.

Minimally Invasive Neuroendoscopy

Similar to minimally invasive endonasal endoscopic surgery, neuroendoscopy uses endoscopes to remove brain tumors. This kind of surgery may also involve small, dime-sized holes in the skull to access parts of the brain.

The Risks of Brain Surgery

All surgical procedures carry some sort of risk. Considering brain surgery is a major medical event, and it carries extra risk.

Possible risks associated with brain surgery include:

  • allergic reaction to anesthesia
  • bleeding in the brain
  • blood clot
  • brain swelling
  • coma
  • impaired speech, vision, coordination, or balance
  • infection
  • memory problems
  • seizures
  • stroke

How to Prepare for Brain Surgery

Your doctor will give you complete instructions on how to prepare for the procedure.

Tell your doctor about any medications you are taking, including over-the-counter medicine and nutritional supplements. You most likely will have to stop taking these medications days before the procedure. Inform your doctor of any prior surgeries, allergies, or if you have been drinking a lot of alcohol.

You may be given a special soap to wash your hair with prior to surgery.

Also, pack whatever belongings you may need while you stay at the hospital.

Following Up After Brain Surgery

Immediately after the surgery, you’ll be closely monitored to ensure everything is working properly. You will be seated in a raised position to prevent swelling in your face and brain.

Recovery from brain surgery depends on the type of procedure done. A typical hospital stay for brain surgery can last up to a week or more, depending on how well your body responds after surgery. You will be on pain medications during this time.

Before you leave the hospital, your doctor will explain the next steps of the process, including caring for the wound, if you have one.

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