Craniotomy or Tumour Excision 

Craniotomy is a major brain surgery that treats tumours, blood clots, and epilepsy. During the surgery, a neurosurgeon removes a part of your skull to access the brain and reapply the piece of your skull back.  

Why Do You Need a Craniotomy? 

You may need a craniotomy in case of: 

• A brain tumour. 

• A blood clot. 

• Abnormal collection of blood vessels or vascular malformations. 

• Enlargement of artery or aneurysm. 

• Tangled blood vessels or arteriovenous malformations. 

• Swelling in your brain. 

• Epilepsy. 

• Fracture in the skull. 

Are There Any Risks Associated with a Craniotomy? 

Any surgery involves certain risks and complications. Since, craniotomy is a major surgical procedure, the common complications include: 

• Pain. 

• Bleeding. 

• Seizures. 

• Stroke. 

• Haematoma. 

• Coma. 

• Headaches. 

• Infection. 

Although, at times craniotomy can also affect your ability to move, think, speak, and function properly. In rare cases, you may show the following long-term side effects: 

• Problems with balance and coordination. 

• Difficulty walking. 

• Change in your behaviour. 

• Trouble with speech and pronunciation. 

• Change in your appearance. 

What Happens During a Craniotomy? 

During a craniotomy, you will first receive an anaesthesia. The neurosurgeon will start the procedure by first shaving any hair at the incision site and sterilising your head to reduce the risk of infection. After this, an incision will be created on your skin and adjust or move muscles around your skill. 

Next, the surgeon will drill several holes and cut in between each hole with a medical saw to remove a piece of your skull. This piece would be secured to close your skull at the end of the surgery. 

After this, the surgeon will treat your condition, fit the skull back into place, and close up the incision in your skin. 

What Happens After a Craniotomy? 

A craniotomy may take up to 3 to 5 hours. After the procedure, you will be moved to an intensive care unit (ICU) to monitor your healing. You will likely stay in the hospital for up to a week after the surgery.  

You can expect complete recovery after six to eight weeks of the procedure. 

Brain tumour resection refers to a surgical procedure to treat or remove brain tumour.  

What are the Types of Brain Tumour Surgery? 

Depending on your condition, your neurosurgeon may perform a brain surgery with any of the following approaches: 

• Craniotomy: 

A craniotomy is one of the most common types of surgery that removes a part of a brain tumour. The procedure involves making an incision in the scalp and removing a piece of bone from the skull to access the tumour.  

• Magnetic Resonance Imaging (MRI)- Guided Laser Ablation: 

MRI-guided laser ablation is a minimally invasive neurosurgical procedure that treats several diseases including brain tumours. The treatment involves the use of a laser to target and destroy the tumour. This helps the surgeons in addressing the most serious brain tumours such as glioblastoma which are hard to access through open surgery.  

Moreover, this procedure results in reduced pain and shorter recovery time. 

• Endoscopic Brain Tumour Surgery (Neuroendoscopy): 

Neuro-endoscopy is also a minimally invasive surgical procedure during which the neurosurgeon removes the tumour through a small hole in the skull or through the nose or mouth. This allows the surgeon to access areas of the brain that cannot be reached with open surgery.  

• Tubular Retractor System: 

A tubular retractor system is a new, minimally invasive procedure that helps neurosurgeons in treating severe brain tumours. 

A retractor is an instrument that holds or moves tissue and allows the surgeon to reach a particular area. It is a valuable instrument as it moves aside the folds and delicate tissues of the brain with a lesser risk of damage than other surgical methods. 

This method is especially useful in conditions when a tumour is located deep in the brain.  

Glioma refers to a tumour in the glial cells in the brain. In the central nervous system (CNS), glial cells are responsible for supporting nerves and helping your CNS work properly. Gliomas are generally malignant; however, some can be very slow-growing. 

What Are the Symptoms of Gliomas? 

The common symptoms of gliomas include: 

• Aphasia or problems with speaking and communicating. 

• Changes in your vision. 

• Difficulty walking or keeping a balance. 

• Cognitive problems. 

• Headaches. 

• Dizziness. 

• Nausea and vomiting. 

• Seizures. 

What Are the Complications of Gliomas? 

Gliomas are life-threatening as they can lead to: 

• Hydrocephalus or accumulation of CSF in the brain. 

• Brain haemorrhage. 

• Brain herniation. 

• Seizures. 

How Are Gliomas Treated? 

The treatment for gliomas will depend on the location, type, or size of the tumour. The treatment will include the following: 

• Surgery: 

Your neurosurgeon may perform an open brain surgery or craniotomy to remove gliomas. If feasible, laser ablation may also help in removing the tumour. 

• Radiation: 

During this procedure, the surgeon will use a powerful dose of radiation to destroy tumours.  

• Chemotherapy: 

Additionally, your neurosurgeon will also use certain drugs to destroy cancer cells.  

Meningioma refers to a tumour that develops in your meninges. Meninges are layers of tissues that cover and protect your brain and spinal cord. Meningiomas start growing in the arachnoid cells and cover your brain and spinal cord.  

What Are the Symptoms of Meningioma? 

Since meningiomas are slow-growing tumours, they may not show symptoms until they grow large and push other structures around them. The common symptoms to watch out for are: 

• Unexplained headaches. 

• Nausea and vomiting. 

• Dizziness. 

• Changes in your vision including double vision or loss of vision. 

• Seizures. 

• Memory problems. 

• Behavioural or personality changes. 

• Muscle weakness in certain parts of your body. 

• Paralysis in certain parts of your body. 

How Are Meningiomas Treated? 

A treatment for meningioma includes the following: 

• Surgery: 

Surgical resection refers to the surgical removal of the tumour. This method is the primary choice or “gold standard” for removing symptomatic meningiomas or large tumours that may show symptoms soon. 

A total removal or gross total resection surgery may cure the majority, that is, 70-80% of people with meningiomas. The goal of this surgery is to prevent the recurrence of a tumour after the surgery. 

• Radiation: 

In addition to surgery, your neurosurgeon may also use radiation therapy to kill cancer cells or keep them from growing or dividing.  

• Chemotherapy: 

A neurosurgeon may also administer certain drugs that work against the cancer. 

What Are the Risks of Meningioma Surgery? 

Surgical removal of meningioma is a complex procedure that also involves certain risks, including: 

• Swelling in the brain after the surgery. 

• Brain damage. 

• Injury to cranial nerves that affect your ability to move your face. 

• Fluid accumulation in or around your brain after the surgery. 

• Accidental damage to normal brain tissue may impair your ability to speak, see, and think. 

Pituitary tumours or pituitary adenomas are benign or non-cancerous growths on your pituitary gland.  

The pituitary gland in your body is responsible for secreting several hormones. A tumour in this gland can affect your normal hormonal balance and lead to a variety of symptoms. 

What Are the Symptoms of Pituitary Tumour? 

The symptoms of a pituitary tumour depend on two factors: 

• Whether it is large enough to damage your pituitary gland or nearby structures. 

• Whether it is a functioning pituitary tumour based on the type of hormone it secretes. 

In general, the tumour may cause: 

• Hormonal deficiency. 

• Headaches. 

• Vision problems. 

• Male and female infertility. 

• High blood pressure. 

• Muscle weakness. 

• Type 2 diabetes mellitus. 

How are Pituitary Tumours Treated? 

The treatment for pituitary tumours involves the following: 

• Surgery 

If you have a pituitary tumour that is causing hormonal imbalance, your neurosurgeon will suggest immediate surgery. Depending on the type, size, and location of your tumour in the gland, you may need multiple surgeries. 

In general, your neurosurgeon will perform a transsphenoidal surgery to remove a pituitary tumour through your nose or sphenoid sinus, a hollow space in your skull behind your nasal passages.  

If the tumour is too large to be removed from your sinus, the surgeon may perform transcranial or open surgery. 

• Radiation 

In addition to surgical procedures, the neurosurgeon may also use high-energy X-rays to shrink the tumour.  

• Chemotherapy 

Some pituitary tumours may also require certain medications to shrink the tumour and relieve symptoms. 

What Are the Risks Associated with Pituitary Tumour Surgery? 

Pituitary tumour surgery is a critical procedure and may involve the following risks: 

• Bleeding. 

• Leaking of CSF in the brain. 

• Meningitis. 

• Impaired fertility. 

• Vision loss. 

• Recurrence of tumour after several years. 

A spinal tumour refers to an abnormal growth in your spinal cord or cells surrounding your spinal cord. These tumours can be found: 

• Inside your spinal cord. 

• In the meninges or covering of your spinal cord. 

• Between the meninges and bones of your spine. 

• In the bony vertebrae of your spine. 

What Are the Symptoms of Spinal Cord Tumours? 

The common symptoms of the spinal cord include: 

• Numbness. 

• Spasms or muscle twitches. 

• Stiff back or neck. 

• Loss of bowel or bladder control. 

• Scoliosis. 

• Paralysis. 

• Difficulty walking. 

How is a Spinal Tumour Treated? 

Based on your symptoms, a spinal tumour is treated with the following approaches: 

• Chemotherapy. 

• Radiation therapy. 

• Surgery: If your cancer is malignant and cannot be treated with drugs and radiation, your doctor may suggest surgery to relieve pain and preserve your neurologic function.