Brain surgery is performed to treat/correct/repair the structural or physical problems/abnormalities of the brain.
The surgery is required in the following cases:
Tumor of the brain
Blood clot formation in the brain
Damage to the protective brain tissue
Damage to the nerves
Infections (brain abscess)
Weak/damaged blood vessels in the brain
To treat epilepsy
Fracture of the skull
Injury causing pressure on the brain
Severe pain in the nerves of the brain as in trigeminal neuralgia
In case of an implantable device placed in the brain as in Parkinson’s disease
Certain laboratory and radiological investigations will be done. Radiological investigations like CT scan, MRI, magnetoencephalography (MEG), positron emission tomography (PET) play a vital role in the diagnosis as well as the operative phases of the surgery.
You will be asked to temporarily stop taking medications like aspirin that cause increased risk of bleeding.
You will be on fasting 8-12 hours prior to the surgery.
The hair on the part of the scalp where incision will be made are shaved off and the area is cleaned.
In conventional craniotomy, an incision is made on the part of the scalp depending upon the part of the brain to be treated. A hole is made in the skull and the bone flap is removed. The bone flap is usually placed back after the surgery is performed and is secured using wires, sutures or metal plates.
Craniectomy: In some cases like when swelling is expected post surgery or when there is trauma to the bone itself, the bone may not be replaced or may be replaced later. When it is to be replaced later, it is protected and preserved in the patient’s body at another location. In case the bone flap is damaged and cannot be replaced, reconstruction with an artificial bone is done later.
It is done to remove tumors, to treat an aneurysm, to drain blood and fluid from an infectious site or to remove damaged brain tissue.
After you recover from anesthesia, you will be asked simple questions to ensure that your brain is functioning properly. There is usually swelling of the head and face after the surgery, to reduce which your head will be kept elevated.
Medicines for relieving pain will be given.
Physical therapy will be started at a safe pace.
Hospital stay of up to 7 days or even more may be required. Recovery will depend on several factors:
Overall health of the patient
Age of the patient
Type of surgery performed
The condition being treated
Part of the brain affected
Risk and Complications
The surgery is performed under general anesthesia and thus there is a risk of reaction to anesthetic medications and there may be breathing problems.
There may be problems with speech, vision, memory, balance, coordination etc.
There is risk of bleeding or blood clot formation. Infection may also occur. Brain swelling may be caused.
There is also risk of seizures, stroke and coma.
Brain surgery is also referred as craniotomy, neurosurgery, craniectomy, minimally invasive endonasal endoscopic surgery, minimally invasive neuro endoscopy.
Do all conditions require a similar surgery?
No. The type of surgery required will depend on the condition to be treated and the area of the brain affected. Some cases will require conventional open surgery while others can be treated by minimally invasive endoscopic surgeries.
What are minimally invasive brain surgeries?
More recently, endoscopy has been introduced for brain surgery.
An endoscope is inserted and surgery is performed with tools inserted through the endoscope. MRI or CT scanning guides the surgeon during the procedure.
In Endonasal endoscopy, the tumor is accessed through the nose and the sinuses. This surgery is used for removing tumors of the pitutary gland and those in the base of the skull.
In neuro endoscopy, an endoscope is inserted through a small opening in the skull.
What is an epilepsy surgery?
For treatment of epilepsy that does not respond to/ineffective to medications, a brain surgery may be done to control seizures. Surgical procedure may be performed to remove the area of the brain that produces seizures, to interrupt the seizure impulses along the nerve pathway or to implant a neuro stimulator device.
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