What is Brain Tumor Surgery?
Surgery is usually the preferred treatment when a patient is diagnosed with a brain tumour. It involves the surgical removal of the tumour from the brain either completely or partially. It is usually the treatment of choice for benign (non-cancerous) and malignant (spreading) tumours that can be removed without damage to the surrounding structures. Brain tumour surgery may be indicated to:
- Obtain a tissue sample and confirm the type of tumour
- Remove a part or complete tumour to minimize symptoms caused by the tumour pressing against surrounding structures
- Remove a part of the tumour at an initial stage so that the amount of radiotherapy or chemotherapy that will be required to treat the inoperable part of the tumour can be minimized
- Allow access for radiation implants or chemotherapy
- Relieve seizures caused by a brain tumour
Pre-surgery Procedures
Before surgery, the following preparations may be required:
- Blood tests and heart function tests to determine if you are healthy to recover from the surgery
- MRI or CT scans to exactly locate the tumour
- Cerebral angiogram to identify the blood vessels around the tumour so that your surgeon can avoid damaging them
- Electroencephalogram (EEG) to test the electrical activity of the brain and detect abnormalities that could indicate seizures
- Medications to prevent seizures and infection
Surgical Treatment for Brain Tumor
Common brain tumour surgical procedures include:
- Biopsy: Removal of a small part of the tumour for analysis
- Craniotomy: Removal of a part of the skull to gain adequate access to the tumour and subsequent replacement of the skull once the surgery is complete
- Craniectomy: Removal of a part of the skull to gain adequate access to the tumour without its subsequent replacement on completion of the surgery
- Debulking: Removal of part of the brain tumour to reduce its size
- Partial removal: Removal of only part of the tumour to avoid neurological injury
- Complete removal: Removal of the entire tumour when it is in an easily accessible location
- Shunt placement: Insertion of a drain to remove excess fluid
- Ommaya reservoir: Insertion of a small container connected to a tube under the scalp to deliver chemotherapy, or remove cerebrospinal fluid (fluid found in the brain) or cystic fluid (fluid-filled sac) from the brain
- Skull base surgery: Removal of tumour from the skull base, underside of the brain, or first few vertebrae
- Trans-sphenoidal surgery: Surgical removal of a tumour in the brain through the nose and the sphenoid bone of the face
- Laser interstitial thermal therapy (LITT): a Minimally invasive procedure used to ablate (burn) poorly accessible or deep brain tumours with heat
Post-Brain Tumor Surgery
Following brain tumour surgery, you may be in the hospital for 2-5 days. The recovery period will vary depending on the location of the tumour, the type of surgery, and the patient’s age and health. Rehabilitation specialists may be required to aid in recovery. These include physical therapists to improve your strength and balance, occupational therapists to ensure that you return to activities of daily living, and speech therapists to aid in speech and swallowing issues. Before discharge, you will be given information regarding the healing process and signs and symptoms to watch out for.
Risk factors of Brain Tumor Surgery
As with any surgical procedure, brain tumour surgery may be associated with certain potential risks and complications such as bleeding, infection, blood clots, brain swelling, meningitis, seizures, problems with balance and coordination, cognitive or memory impairment, leakage of cerebrospinal fluid, coma and death.