NEUROSURGERY OF BRAIN

OVERVIEW

In neurology,  neurosurgery  of brain or in simpler terms brain surgery refers to the various medical procedures that involve the repairing of the structural problems in the brain.

Brain surgery is used to treat a variety of conditions related to brain and to the nervous system in general such as tumors, blood clots, aneurysms, epilepsy, Parkinson’s disease.

Neurosurgery of brain is a very complicated and critical process. The type of surgery done on the brain entirely depends on the type of disease it is being done for.

Neurosurgery of brain is not that common procedure, but its survival rate is very high so one need not to worry while thinking to undergo one.

PURPOSE OF BRAIN SURGERY

The main purpose of neurosurgery of brain is to get the patient rid of the brain disease, that he or she is having.

The diseases that the patient has might be due to birth defect, disease, injury or any other problems.

The person might need neurosurgery of brain if he or she has any of the following conditions in or around the brain.

• Bleeding
• Blood clots
• An aneurysm
• Abnormal blood vessels
• Damage to the protective tissue called the dura
• Epilepsy
• Abscesses
• Nerve damage or nerve irritation
• Parkinson’s disease
• Pressure after head injury
• Skull fracture
• A stroke
• Brain tumors
• Fluid building up in the brain

Not all of the above conditions require a neurosurgery of brain, some of them can be cured by correct treatment or medications.

TYPES OF BRAIN SURGERY

There are several types of neurosurgery of brain that are being practiced. Some of them are listed below.

Craniotomy

• In craniotomy a piece of the skull is removed to give the doctor access to the brain to remove a brain tumor, abnormal tissue, blood or blood clots, relieve pressure after an injury or stroke, repair a brain aneurysm or skull fractures, or treat other brain condition.
• The piece of the skill is put back in place after surgery.

  Neuro-endoscopy

• This is a minimally invasive technique that involves threading a thin tube called an endoscope through the mouth, nose, or small incisions in the skull to access or remove brain tissue.
• The endoscope has a light and camera on the end, and the surgery is performed with tools placed through the endoscope.
• Endoscopic transsphenoidal surgery that is also called endoscopic pituitary surgery is one type of neuroendoscopy.
• It involves threading the endoscope through the nose to remove brain tumors and lesions near the pituitary gland, just behind the bridge of the nose.

Biopsy.

• Biopsies are typically done after imaging has detected a potential abnormality.
• The surgeon makes an incision in the skull or inserts a needle to remove brain cells or tissue for examination by a pathologist.

Deep brain stimulation (DBS).

• A battery-operated medical device called an implantable pulse generator is implanted to deliver electrical stimulation to specific areas in the brain.
• DBS is most commonly used for movement disorders like Parkinson’s disease.

Posterior fossa decompression.

• This treatment involves parts of the brain called the cerebellum and brainstem.
• For example, to treat a Chiari malformation, the surgeon makes an incision at the back of the patient’s head to remove a small portion of the bone at the bottom of the skull.
• This removal creates more space for the cerebellum and relieves pressure on the spinal cord.

Posterior fossa decompression.

• This treatment involves parts of the brain called the cerebellum and brainstem.
• For example, to treat a Chiari malformation, the surgeon makes an incision at the back of the patient’s head to remove a small portion of the bone at the bottom of the skull.
• This removal creates more space for the cerebellum and relieves pressure on the spinal cord.

 

RISKS OF NEUROSURGERY OF BRAIN

Brain surgery comes with few risks as well despite of making much progress made in terms of safety and precision. Some of the risks of neurosurgery of brain are listed below :

• Bleeding:

Neurosurgery of brain can cause unforeseen bleeding in the brain region which may be resolved if it happens under medical observation.

• Allergic reactions :

Reactions to anaesthesia have been noted I some cases which might be one of the risks of neurosurgery of brain

• Brain swelling:

Swelling can occur  due to trauma or fluid build up in the brain after a brain operation.

• Blood clots :

Thrombosis in the brain can cause a stroke  if left unattended and a brain surgery may sometimes have this as a side effect.

• Coma :

If by chance, the neurosurgery of brain  is unsuccessful, a patient may fall into a lengthy period of unconsciousness called coma, and sometimes may go into a vegetative state. However,most brain surgeries today show a high rate of success, and the occurance of such a case is rare.

• Infection :

Infection in the area where the brain surgery procedure was carried out can cause complications such as swelling and further brain damage.

• Amnesia :

Short-term or long-term memory loss may occur due to nerve damage during brain surgery.

• Impairment of bodily functions :

Speech, vision and motor coordination are all controlled by the nervous system, and brain damage due to brain operation can affect any of these functions.

• Seizures :

Seizures may be triggered during brain surgery in certain cases, and may be causes by damage to the nerve centers in the brain.

 

DURING SURGERY PROCEDURE

• An anesthesia specialist (anesthesiologist) will give you some medication to make you sleepy for parts of your awake brain surgery. Your neurosurgeon will apply numbing medications to your scalp to ensure your comfort.
• During the procedure, doctors place your head in a fixed position to keep your head still and ensure surgical accuracy. Some of your hair will be clipped. Your surgeon then removes part of your skull to reach your brain.
• If your brain tumor or epileptic focus is close to areas of your brain that control vision, speech or movement, your doctor will conduct brain mapping. This provides your neurosurgeon with a map of the brain centers that control each of these functions. Your surgeon also can perform brain mapping deeper in your brain during surgery.
• During surgery, your neurosurgeon or a speech-language pathologist may ask you questions or ask you to identify pictures and words on cards or computer that you saw before surgery. Your doctor may ask you to make movements, identify pictures on cards, count numbers or raise a finger. Your responses help your surgeon identify and avoid the functional areas in your brain.
• Your anesthesiologist and surgical team carefully monitor and assess your body and brain functions and alerts your surgeon if surgery affects brain function.

 

RECOVERY AFTER NEUROSURGERY OF BRAIN

Neurosurgery of brain is a gradual process and it can take about two months, and sometimes more. It eventually improves the quality of patient’s life and is worth the patience. A recovery plan is created by the team of neurosurgeons who are treating you. All the steps of the treatment plan after brain surgery must be followed so that subsequent complications are avoided.