Surgical Procedures for Brain Tumors
by Michael Jubinville, MPH
Surgery is done to remove or shrink the size of the tumor. This can lead to a cure. But, certain tumors do grow back. The impact on how the brain works depends on the type of tumor and what surgery is needed.
Taking out some of the tumor may help ease pressure on other structures. It may also help relieve more serious problems. Surgery can help improve outcomes of other treatments you may need.
During surgery, biopsies are taken. These are tissue samples and they will be looked at in a lab. A biopsy can also be done by itself. Sometimes, tumors can't be removed. A type of biopsy is done by inserting a needle through a small hole in the skull.
This is a method a doctor uses to see what function is connected to what part of the brain. Mapping tests places in and around the tumor. This helps find what can be taken or what problems may happen after surgery. This is done by:
Options for Surgery
Open craniotomy is the removal of a piece of the skull. Some tumors are best removed through the nose or the top of the neck. But, most go through the skull. The placing of the hole depends on where the tumor is. In some cases, the brain may need to be mapped. Brain surgery may take several hours.
Types of craniotomies:
Once inside, the tumor may be treated with:
A biopsy can also be done during a craniotomy.
The blood supply can be found by an angiography. It can then be shut off by placing plugs in the blood vessels that supply the brain. The tumor tissue may die from lack of blood. This procedure is rarely done.
Other Surgical Options
Some surgery may be done to ease problems caused by a brain tumor. They can also be used to deliver other treatments.
Tumors can block the flow of cerebrospinal fluid (CSF) in the skull. This makes pressure in the brain higher. A cerebral shunt may be done if pressure is causing problems. The shunt helps manage the level of CFS. Shunts are named for the way they are routed through the body. For example, a ventriculoperitoneal (VP) shunt drains fluid from the brain to the belly. The CSF is then taken in by the body.
A shunt is created by making a small hole in the skull. A tube is placed into one of the fluid filled spaces inside the brain. The other end of the tube is passed under the skin from the head to the trunk. It will drain fluid into the heart or belly. A one-way valve in the tube prevents fluid from flowing backwards. Some types of cancer cells can travel through the CSF to other parts of the body. Your doctor will talk about your risk beforehand.
Ventricular Access Catheter
There is a barrier around the brain that blocks certain medicines from going into the brain. A ventricular access catheter (VAC) allows the medicines to be passed directly to the brain and surrounding fluid to treat the tumor.
A small hole is made in the skull. A tube is inserted into the fluid-filled space inside the brain. The other end of the tube contains a reservoir, which remains under the scalp. Medicines are given by a putting a small needle into the reservoir.
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Last reviewed May 2018 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP
Last Updated: 8/9/2018
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