Q1. What does the term brain surgery mean?
Brain Surgery is performed to treat/correct/repair the structural or physical abnormalities of the brain.
Q2. When is a brain surgery required?
Typically, an experienced neurosurgeon will recommend the surgery following cases:
- Brain Tumor
- Brain hemorrhage
- Blood clot formation in the brain
- Damage to the protective brain tissue
- Damage to the nerves
- Infections (brain abscess)
- Weak/damaged blood vessels in the brain
- To treat epilepsy
- Fracture of the skull
- Injury causing pressure on the brain
- Severe pain in the nerves of the brain as in trigeminal neuralgia
- In case of an implantable device placed in the brain as in Parkinson’s disease
Q3. Which medical terms are typically used for brain surgery?
It may be called as craniotomy, neurosurgery, craniectomy, minimally invasive endonasal endoscopic surgery, minimally invasive neuro endoscopy.
Q4. Do all conditions require a similar surgery?
No. The type of surgery required will depend on the condition to be treated and the area of the brain affected. Some cases will require conventional open surgery while others can be treated by minimally invasive endoscopic surgeries.
Q5. What measures are taken before the procedure?
Certain laboratory and radiological investigations will be done. Radiological investigations like CT scan, MRI, magnetoencephalography (MEG), positron emission tomography (PET) play a vital role in the diagnosis as well as the operative phases of the surgery.
Typically, the neurosurgeon will suggest to temporarily stop taking medications like aspirin that cause increased risk of bleeding. Fasting 8-12 hours prior to the surgery will also be advised.
Q6. How are craniotomy and craniectomy carried out?
The hair on the part of the scalp where incision will be made are shaved off and the area is cleaned.
In conventional craniotomy, an incision is made on the part of the scalp depending upon the part of the brain to be treated. A hole is made in the skull and the bone flap is removed. The bone flap is usually placed back after the surgery is performed and is secured using wires, sutures or metal plates.
Craniectomy: In some cases like when swelling is expected post surgery or when there is trauma to the bone itself, the bone may not be replaced or may be replaced later. When it is to be replaced later, it is protected and preserved in the patient’s body at another location. In case the bone flap is damaged and cannot be replaced, reconstruction with an artificial bone is done later.
It is done to remove tumors, to treat an aneurysm, to drain blood and fluid from an infectious site or to remove damaged brain tissue.
Q7. What are minimally invasive brain surgeries?
More recently, endoscopy is being done for brain surgery. An endoscope is inserted and surgery is performed with tools inserted through the endoscope. MRI or CT scanning guides the surgeon during the procedure.
In Endonasal endoscopy, the tumor is accessed through the nose and the sinuses. This surgery is used for removing tumors of the pitutary gland and those in the base of the skull. In neuro endoscopy, an endoscope is inserted through a small opening in the skull.
Q8. What is an epilepsy surgery?
For treatment of epilepsy that does not respond to/ineffective to medications, a brain surgery may be done to control seizures. Surgical procedure may be performed to remove the area of the brain that produces seizures, to interrupt the seizure impulses along the nerve pathway or to implant a neuro stimulator device.
Q9. What can be expected after the procedure?
A9. After recovery from anesthesia, simple questions are asked to ensure that the brain is functioning properly. There is usually swelling of the head and face after the surgery. To reduce this head will be kept elevated. Medicines for relieving pain will be given. Physical therapy will be started in a couple of days.
Hospital stay of up to 7 days or even more may be required.
Q10. What are potential risks and complications of a neurosurgery?
Although a relatively safe procedure if performed by an experienced neurosurgeon, typically following risks are associated with neurosurgery –
- The surgery is performed under general anesthesia and thus there is a risk of reaction to anesthetic medications and there may be breathing problems.
- There may be problems with speech, vision, memory, balance, coordination etc.
- There is risk of bleeding or blood clot formation. Infection may also occur. Brain swelling may be caused.
- There is also risk of seizures, stroke and coma.
Q11. What is the recovery period after a neurosurgery?
Recovery will depend on several factors:
- Overall health of the patient
- Age of the patient
- Type of surgery performed
- The condition being treated
- Part of the brain affected
This write-up was contributed by Credihealth content team:
Credihealth is a medical assistance company that gives guidance to a patient from the first consultation through the entire hospitalization process. A team of in-house Credihealth doctors helps the patient find the right doctor, book appointment, request cost estimate for procedures and manage admission & discharge processes.
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