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Brain Tumour Surgery (Neurosurgery)
On this page you will find lots of information about different types of brain tumour surgery, to help you know what to expect.
I have a far better idea of what to ask my consultant when I next see him and what the long term implications will be. This has given me more sense of not only an understanding of my situation, but I feel like I have regained some control of the situation and my life again.
I really cannot thank-you enough for your help with this. I had no idea where to turn or what to do and although there is still very much a long way to go and many decisions to be made, which will no doubt be hard, I feel better prepared and feel that if I need help I am not alone, but that I can turn to you.
Thank-you, from the very bottom of my heart,
Nadia, brain tumour patient, London
Brain surgery. Scary words. If you are reading this then it is highly likely you have recently learnt that you are going to have neurosurgery. This is one of the first major decisions you will face. In fact, I don’t think there is anything as frightening as facing this decision – ever. If you can make this decision – one way or the other – then nothing you do will ever be as scary as this.
But you are not facing this alone. You will have a brilliant team behind you, your family will be there and of course, brainstrust is just a call away.
No decision is going to be straightforward. It’s all a balance of risk v. benefits and the truth is that there is seldom a good reason to remove a brain tumour unless it is thought that the vast majority can be removed. Partial resection can sometimes be a bad thing. What we’re saying here is that each case needs to be decided individually; so much depends on your quality of life, type of brain tumour, where it is. The list goes on.
First decision – whether to proceed with an attempted complete surgical removal or whether to have just a biopsy. Evidence shows that wherever possible it is better to resect as much as is possible. Surgery to remove a tumour, even malignant ones, has several advantages over a biopsy:
- By removing tumour mass, room can be made to allow for the swelling of brain tissue which occurs both with radiation therapy and if the tumour recurs.
- The more that can be taken out, the less that will need to be treated with other forms of therapy.
- More tumour to diagnose, means better accuracy of the diagnosis and grading, because there are more cells to examine.
Everything depends on the individual’s well being, the nature of the tumour, and potential complications. All of these must be talked through and thought about. And thought about some more. But don’t think for too long. It can be very wearying and will occupy your head so that in the end you will not feel able to make a decision. And no decision is irreversible – until you go down to the operating theatre.
Here is a really clear video which explains about why you might need surgery, what the different types of surgery are and what happens after surgery. It is Australian – so just make allowances for differences in our healthcare systems. And one day we will make our own!
Types of neurosurgery
This is the most generally used procedure, which involves removing a piece of skull and then replacing it, under a general anaesthetic. It is called a craniotomy because this procedure removes part of the cranium – the skull. And image-guided refers to the use of scans and a computer to precisely locate and target a lesion within the brain. All craniotomies for brain tumours are image guided.
Nowadays your scan can be performed in advance of your surgery (without a frame on), the data is uploaded onto a computer in the operating room, and a navigation system is used to locate the tumour (frameless stereotaxy or image-guidance). This technique is beneficial because it localises the tumour, so the operation is shorter and the area of the head that the surgeon must disrupt is often smaller.
Find out more about image guided craniotomy - click here.
An awake craniotomy is an operation performed in the same manner as a 'conventional' craniotomy but with the patient awake during the procedure.
Find out more about awake craniotomy - click here.
Meg to have her surgery. This technology has been around for about twenty years in the USA and was pioneered by Prof. Peter Black. It is now available in the UK. For more information about availability speak to brainstrust.
Read more about Intraoperative MRI - click here
Read more about lasers in brain surgery - click here
Read more about preparing for neurosurgery. Click here.
Back to brain tumour treatment information
Resources used to create this page:
National Institute for Health and Clinical Excellence guidelines – Improving Outcomes Guidance Brain and CNS Tumours 2006
Living with a Brain Tumour (Peter Black) 2006
Fast Facts – Brain Tumors (Abrey and Mason) 2009
Primary Central Nervous System Tumors – pathogenesis and therapy (Current Clinical Oncology, Humana Press 2011
Navigating Life with a Brain Tumour, L. Taylor, F. Alyx B. Umphrey, D. Richard (2013)