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Brain surgery - Overview

Alternative Names

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

Definition of Brain surgery:

Brain surgery is a procedure to treat problems in the brain and the surrounding structures.

Description:

Before surgery, the hair on part of the scalp is shaved, and the area is cleaned. The doctor makes a surgical cut through the scalp. The location of this cut depends on where the problem in the brain is located.

The surgeon creates a hole in the skull and removes a piece, called a bone flap.

If possible, the surgeon will make a smaller hole and insert a tube with a light and camera on the end. This is called an endoscope. The surgery will be done with tools placed through the endoscope. MRI or CT can help guide the doctor to the proper place in the brain.

During surgery, your surgeon may:

  • Clip off an aneurysm to prevent blood flow
  • Remove a tumor or a piece of tumor for a biopsy
  • Remove abnormal brain tissue
  • Drain blood or an infection

The bone flap is usually replaced after surgery, using small metal plates, sutures, or wires. The bone flap may not be put back if your surgery involved a tumor or an infection, or if the brain was swollen. (This is called a craniectomy.)

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:

  • Brain tumor
  • Bleeding (hemorrhage) in the brain
  • Blood clots (hematomas) in the brain
  • Weaknesses in blood vessels (See: Brain aneurysm repair)
  • Abnormal blood vessels in the brain (arteriovenous malformations; AVM)
  • Damage to tissues covering the brain (dura)
  • Infections in the brain (brain abscesses)
  • Severe nerve or face pain (such as trigeminal neuralgia or tic douloureux)
  • Skull fracture
  • Pressure in the brain after an injury or stroke
  • Epilepsy
  • Certain brain diseases (such as Parkinson' s disease) that may be helped with an implanted electronic device
  • Reviewed last on: 2/9/2011
  • Luc Jasmin, MD, PhD, Department of Neurosurgery at Cedars-Sinai Medical Center, Los Angeles, and Department of Anatomy at UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Ortiz-Cardona J, Bendo AA. Perioperative pain management in the neurosurgical patient. Anesthesiol Clin. 2007 Sep 01;25(3):655-74, xi

Patterson JT, Hanbali F, Franklin RL, Nauta HJW. Neurosurgey. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 72.

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