Treatments for the Brain

Brain tumor surgery for primary and metastatic tumors

There are sev­er­al types of surg­eries to treat or remove brain tumors, includ­ing biop­sies and cran­iotomies. Patients and doc­tors togeth­er can deter­mine which method is treat­ment is best for them.


Craniotomy

A cran­ioto­my is a sur­gi­cal pro­ce­dure in which a piece of the skull is removed so the sur­geon may access the brain beneath. The cut-away por­tion, called the bone flap, may be small or large and is typ­i­cal­ly put back in place after surgery on the brain is fin­ished the inci­sion closed. A cran­ioto­my may be required for the sur­gi­cal treat­ment of a vari­ety of neurological/brain dis­or­ders, includ­ing:

  • Cancer/tumor
  • Infec­tion
  • Edema/swelling
  • Hematoma (blood clot)
  • Aneurysm (blood ves­sel rup­ture)
  • AVM (blood ves­sel dis­or­der)
  • Skull frac­ture
  • For­eign object removal

In addi­tion to pro­vid­ing access to the brain, a cran­ioto­my also allows a sur­geon to inspect the brain for abnor­mal­i­ties, per­form a biop­sy or relieve pres­sure inside the skull.


Stereotactic Radiosurgery and Radiotherapy for Tumors

Stereo­tac­tic radio­surgery and radio­ther­a­py are treat­ment options for some types of tumors. They use high-pow­ered x-rays to tar­get tumors and are con­sid­ered radi­a­tion treat­ments rather than surgery.


Microvascular Decompression (MVD) of the Trigeminal Nerve for Trigeminal Neuralgia

MVD is a sur­gi­cal pro­ce­dure to relieve the pain and mus­cle twitch­ing caused by com­pres­sion of a nerve by an artery or vein. MVD involves sur­gi­cal­ly open­ing the skull and expos­ing the nerve at the base of the brain­stem to insert a tiny sponge between the com­press­ing ves­sel and the nerve. This sponge iso­lates the nerve from the pul­sat­ing effect and pres­sure of the blood ves­sel. MVD can be an appro­pri­ate treat­ment option for peo­ple who have not respond­ed to med­ica­tion, per­cu­ta­neous or radio­surgery treat­ments. MVD does not suc­cess­ful­ly treat facial pain caused by mul­ti­ple scle­ro­sis.


Shunt surgery for hydrocephalus

This treat­ment to relieve excess flu­id on the brain con­sists of insert­ing a flex­i­ble but study plas­tic tube sys­tem between the brain and abdomen. The sys­tem diverts the flow of excess flu­id to oth­er parts of the body where it can be absorbed as part of the nor­mal cir­cu­la­to­ry process.


Skull base surgery

There are many treat­ment options avail­able to treat dis­or­ders, par­tic­u­lar­ly tumors, of the skull base.


Chiari malformation surgery

For patients with severe symp­toms who do not respond to med­i­cine, surgery to cor­rect the struc­tur­al defects affect­ing the spinal cord and halt the pro­gres­sion of dam­age to the cen­tral ner­vous sys­tem. Sur­gi­cal options include 

  • Decom­pres­sion surgery to cre­ate more space for the cere­bel­lum and relieve pres­sure on the spinal col­umn.
  • The sur­gi­cal removal of part of the arched, bony roof of the spinal canal to increase the size of the spinal canal and relieve pres­sure on the spinal cord and nerve roots.
  • The sur­geon also may make an inci­sion in the cov­er­ing of the brain to exam­ine the brain and spinal cord. Addi­tion­al tis­sue may be added to the brain cov­er­ing to cre­ate more space for the flow of CSF.

Endoscopic Pituitary Tumor Surgery

This is a sur­gi­cal pro­ce­dure to remove tumors of the pitu­itary gland. It uses a small, tubu­lar instru­ment insert­ed through the nos­tril to tar­get the tumor. The endo­scope pro­vides light and mag­ni­fi­ca­tion, and sur­geons use a video mon­i­tor to view images com­ing from the endo­scope.


Treatments for Acoustic Neuroma

These tumors of the nerve that con­nects the inner ear to the brain some­times don’t require treat­ment because they are slow-grow­ing. How­ev­er, tra­di­tion­al surgery to remove the tumor, and stereo­tac­tic radio­surgery are also options. Stereo­tac­tic radio­surgery focus­es high-pow­ered x-rays on a small area. It is con­sid­ered radi­a­tion rather than surgery.