Brain surgery can be performed to treat a wide range of conditions. Some diseases or afflictions that may require brain surgery as treatment include epilepsy, Parkinson’s disease, stroke, brain tumor, and skull fracture. But although today’s medicine is quite advanced, there isn’t one single, universal type of brain surgery. In the operating room, various methods are used depending on the problem at hand. Here are the most common types of brain surgery and what type of situations they are used in.
Craniotomy
A craniotomy is an operation in which part of the skull is removed to provide access to the brain. Surgeons may need to access the brain for a variety of purposes, such as taking an MRI or CT scan, performing a biopsy (the removal of tissue for laboratory analysis), removing a tumor, or draining fluid from a cyst. Sometimes, a surgeon will insert a camera into the skull to view a more detailed image of the brain. After the procedure, the skull is sealed back up using a metal plate or a series of wires.
Biopsy
During a brain biopsy, a surgeon will remove a piece of abnormal tissue from the brain to study it in a laboratory setting. In the lab, doctors can determine if the tissue is cancerous or benign. There are two types of biopsies: an open biopsy, where the skull is opened and a tissue sample is removed, and a needle biopsy, where a needle is inserted into the brain to remove deep-seated tissue.
Endoscopic Endonasal Surgery
Endoscopic endonasal surgery is a minimally invasive procedure, done to remove tumors or treat sinus problems, that does not require making an incision in the skull. Instead, the brain is accessed through the nose, using an endoscope (a type of camera). The camera communicates with a monitor, so the surgeon can determine where to operate. The surgery itself is performed with many specialized tools.
Neuroendoscopy
Another minimally invasive procedure, neuroendoscopy is similar to endoscopic endonasal surgery in that the operation is done by inserting an endoscope into the nose, mouth, or skull to locate and remove abnormal tissue. If the procedure is done through the skull, a very small hole is made in the bone rather than a large incision.
Deep brain stimulation
Deep brain stimulation is a brain surgery usually performed to treat Parkinson’s disease. The treatment involves an electrode wire, or lead, (surgically implanted into the brain) that communicates with a device called a neurostimulator (surgically implanted into the chest). The electrode wire is connected to the neurostimulator through another wire called an extension. The neurostimulator then sends electrical signals to the lead in the brain which block certain symptoms of Parkinson’s, such as tremor, slowed movement, and stiffness/rigidity.
Risks of brain surgery
All types of brain surgery are considered high risk procedures. Some risks of brain surgery include:
- Bleeding or infection in the brain
- Blood clot
- Brain swelling
- Seizure or stroke
- Coma
- Impaired speech or vision
- Problems with memory
- Adverse reaction to anesthesia
Choosing a qualified surgeon can reduce (although not completely rule out) the possibility of an adverse outcome.
Written by Natan Rosenfeld
