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For most patients, removing as much of a brain tumor as possible is typically the best option.
For most patients, removing as much of a brain tumor as possible is typically the best option. This goal has to be weighed against the potential to cause neurological injury (such as the ability to speak, walk etc) as well as the risk of medical complications (such as heart or lung problems). Neurosurgeons specialize in forming an individualized strategy by which to treat tumors as effectively as possible, while minimizing risk to their patients.
The different potential goals of brain tumor:
Definitively diagnose the type of tumor
Remove the tumor totally
Remove as much of the tumor as possible in order to slow the growth and improve symptoms
Remove as much as possible, so as to help other treatments such as Radiotherapy and Chemotherapy work better
The operation by which a brain tumor is removed is called a craniotomy. In this operation, the bone and membranes covering the brain are opened. The surgeon then removes as much of the tumor as possible. At the end of the procedure the membranes are closed again, the bone flap replaced and the skin closed.
Various technologies are used to make the surgery as safe and efficient as possible:
Stereotactic Neuronavigation - The surgeon uses an MRI or CT scan that was done prior to surgery to create a 3D model of the brain and brain tumor. Intraoperatively small cameras and navigation probes are used to guide the surgeon to help identify anatomical areas and tumor tissue.
Surgical Microscope - A microscope that has been specially designed for use during surgery is used during surgery. This helps to light up dark areas during the operation, magnifies the view and allows the surgeon to identify and remove small areas of tumor, while preserving normal brain tissue and blood vessels.
Ultrasonic aspiration - A very small ultrasonic probe is placed onto the surface of the tumor. It then uses high frequency sound waves to break up the tumor, allowing it to be aspirated using gentle suction.
Endoscopic Surgery - An endoscope is a long tube with a camera which is inserted into the surgical field. This then shows an enlarged view of the surgical field on a television screen, which the surgeon and his assistants then use to guide their surgery. Endoscopes allows surgeons to use very small openings to get into cavities inside the brain or at the base of the brain.
Neuromonitoring - This is a technique by which a highly trained technician assists the surgeon with placing small electrodes on the scalp or even on the surface of the brain. The electrodes then continually monitor neural pathways or areas of the brain. This helps the surgeon identify specific functional areas of the brain and to monitor the brain and spinal cord during surgery so as to minimize risk.