Brain surgery

Definition

Brain surgery is an operation to treat problems in the brain and surrounding structures.

Alternative Names

Craniotomy; Surgery - brain; Neurosurgery; Craniectomy; Stereotactic craniotomy; Stereotactic brain biopsy; Endoscopic craniotomy

Description

Before surgery, the hair on part of the scalp is shaved and the skin is cleaned. The surgeon makes a cut through the scalp to expose the bone (skull). The location of this cut depends on where the problem in the brain is located.

The surgeon uses a high speed saw to cut a portion of the bone (a bone flap) to access the brain.

Sometimes, the surgeon will make a smaller hole and insert a tube with a light and camera on the end. This is called an endoscope. In this case, the surgery will be done with tools placed through the endoscope. An MRI or CT scan and a computerized navigation system can help guide the doctor to the proper place in the brain.

During surgery, your surgeon may:

The bone flap is usually placed back at the end of the surgery, using small titanium plates to hold it in place. These plates are MRI compatible. This brain surgery is called a craniotomy.

The bone flap may not be put back if your surgery involved a tumor or an infection, or if the brain was swollen. This brain surgery is called a craniectomy. The bone flap may be put back during a future operation.

The time it takes for the surgery depends on the problem being treated.

Why the Procedure Is Performed

Brain surgery may be done if you have:

Risks

Risks for anesthesia and surgery in general are:

Possible risks of brain surgery are:

Before the Procedure

Your surgeon will examine you and may order laboratory and imaging tests.

Tell your surgeon or nurse:

During the days before the surgery:

On the day of the surgery:

After the Procedure

After surgery, you will be closely monitored by your health care team to make sure your brain is working properly. The surgeon or nurse may ask you questions, shine a light in your eyes, and ask you to do simple tasks. You may need oxygen for a few days.

The head of your bed will be kept raised to help reduce swelling of your face or head. The swelling is normal after surgery.

Medicines will be given to relieve pain.

You will usually stay in the hospital for 3 to 7 days. You may need physical therapy (rehabilitation).

After you go home, follow any self-care instructions you're given.

Outlook (Prognosis)

How well you do after brain surgery depends on the condition being treated, your general health, which part of the brain is involved, and the specific type of surgery.

References

Patterson JT. Neurosurgery. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 68.

Zada G, Attenello FJ, Pham M, Weiss MH. Surgical planning: an overview. In: Winn HR, ed. Youmans and Winn Neurological Surgery. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 18.


Review Date: 1/18/2023
Reviewed By: Luc Jasmin, MD, Ph.D., FRCS (C), FACS, Department of Surgery, Johnson City Medical Center, TN; Department of Maxillofacial Surgery at UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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