A brain tumor is an abnormal growth of cells in the brain due to uncontrolled cell multiplication. Because the skull is a closed space, tumor growth can increase the pressure inside the brain. Most of the brain tumor needs to remove at least for the diagnosis. Craniotomy is the most commonly performed procedure to remove the brain tumor. Craniotomy is a procedure in which a part of the bone in the skull is cut and opened to reach to the tumor. The bone flap is temporarily removed and then placed again after the brain tumor removal surgery.
Depending on the site and extension of the tumor, your surgeon for brain tumor removal may perform one of the following craniotomies. –
There are various other craniotomies that can be performed for the superficial brain tumors like frontal craniotomy, occipital craniotomy, parietal or temporal craniotomy.
There is no one best approach or type of craniotomy for any particular tumor and it is based on your surgeon’s preference and familiarity with such procedures.
There are different types of brain tumors and symptoms depend on the type, size of the tumor, and location of the tumor. Some common symptoms of brain tumors are discussed below-
To confirm the diagnosis, some imaging tests such as MRI, and CT scans are usually done.
If the tumor is benign and static or growing slowly with no pressure on the adjacent tissues or nerves then it can be observed with serial MRI scans without any intervention. But most of the tumors need surgery at least to establish a diagnosis. If the tumor is malignant, it needs further treatment after the brain tumor surgeries like radiation therapy, and/or chemotherapy. If the diagnosis is not clear on the MRI scan, sometimes, your surgeon may offer stereotactic biopsy of the tumor (done by placing a small hole in the skull and inserting a needle to aspirate the tumor cells) to establish a tissue diagnosis.
Then the dura is closed and the bone flap is replaced and fixed with miniplates and screws. Finally, the skin is restored to its original position and sutured.
After the surgery is done, the patient is shifted to ICU or intensive care unit for close monitoring of all the vital signs. Most of the times, the patients are awake before shifting to the ICU. But sometimes, the patient may stay on ventilation or breathing tube support depending on the complexity of the procedure. The patient might feel a headache or nauseated for some time with brain tumor after removal. The patient is required to stay in the hospital for a few days under observation.
The patient is given general anesthesia and the head of the patient is placed on a device to keep it stable during the procedure. Some hairs may be shaved off around the incision area. The incision is made at the skin and the skin and muscles are moved aside.
A craniotomy for brain tumour removal typically takes 3–8 hours depending on the tumour’s size and location. Hospital stay is usually 5–7 days. Patients are monitored in the ICU initially, followed by a general ward. Recovery at home takes 4–8 weeks before return to normal activities.
Risks include bleeding, infection, neurological deficits (speech, movement), and seizures. Dr. Rajeswaran minimizes these risks using intraoperative neuromonitoring, awake craniotomy for eloquent brain areas, and image-guided navigation. The risk profile depends heavily on tumour location and the individual patient’s health.
After craniotomy, patients should avoid driving for at least 6 weeks, refrain from heavy lifting for 8 weeks, and avoid contact sports until cleared by the surgeon. Follow-up MRI is scheduled at 3–6 months to assess resection completeness and monitor for recurrence. Full activity clearance depends on recovery progress.
Department of Neurosurgery - Zulekha Hospital, First Floor - Block B - 204th Rd, Al Nahda - Al Nahda 2 - Dubai
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