Brain Surgery

brain-surgery

Brain surgery is a complicated surgery performed to correct physical or structural issues in the brain. The reason for these physical issues could be due to disease, genetic defects, injuries or any other issues. A neurosurgeon will advise neurosurgery only if found utmost essential or rather as the last option to solve the brain condition of the patient.

Advancements in neurosurgery have made it possible to operate the brain with minimal incisions. At times, brain surgery is performed without making a single incision in the head region or even near it.

Brain surgery is one of the greatest marvels of surgical expertise gained in the history of medical science.


List of brain surgeries performed with regards to the structural issues in the brain

An Aneurysm

An aneurysm in the brain occurs when a weak bulging spot in the brain filled with blood is at risk of tearing or rupturing out.

Brain Aneurysm Repair

  • Clipping -
    In clipping brain surgery, a small clip is based at the base of the aneurysm and to prevent its rupture. This surgery involves an incision into the scalp and creating a hole in the skull.
  • Endovascular Repair -
    In an endovascular repair, the neurosurgeon inserts a wire followed by a catheter through the groin to reach the aneurysm. The neurosurgeon will install thin metal wires which will coil into boil encouraging the formation of a blood clot. This blood clot will prevent the rupture of the aneurysm in the future.

Abnormal Blood Vessels

Abnormal Blood Vessels or an arteriovenous malformation (AVM) is a congenital disorder. It is a tangled web of arteries and veins that could lead to brain haemorrhaging, paralysis or other neurological issues.

Brain repair surgeries for Abnormal Blood Vessels

  • Surgical removal of abnormal vessels, if they are easily accessible. The neurosurgeon performs a craniotomy to remove a part of the skull and seek access to the abnormal blood vessels. The surgeon will either remove the abnormal blood vessels or clip them and remove them from the surrounding brain tissue. The surgeon will restore the brain flap and close the brain.
  • Endovascular embolization is a minimally invasive surgery. The neurosurgeon inserts a catheter into an artery in the leg to reach the abnormal blood vessels in the brain. Following this, the surgeon inserts an embolizing agent or microcoils to prevent the blood flow into the abnormal blood vessels.
  • Stereotactic radiosurgery (SRS) - The stereotatic radiosurgery involves focussed radiation to scar and destroy the abnormal blood vessels located in the brain that cannot be removed by conventional surge

Brain Abscess

Brain Abscess is a life-threatening condition that indicates the presence of pus as a reaction to trauma or infection. A brain abscess is a collection of pus that develops in response to an infection or trauma. It remains a serious and potentially life-threatening condition.

Brain Abscess Repair

The neurosurgeon makes an opening in the skull and gains access into the infected region in the brain. The surgeon removes the pus and the abscess with the assistance of a CT scan. Afterwards, the surgeon closes the skull and stitches the brain.

Bleeding Or Blood Clot

Blood Clots occur in the brain due to blow to the head or repetitive trauma. The surgeon will suggest removing the blood clots with increasing age.

Brain Repair Surgeries for blood clot removal

  • Burr Hole Drainage- The surgeon makes one or more holes in the skull and an incision in the dura followed by draining the cloth and suturing the incision.
  • Craniotomy- The surgeon will open the brain to access the clot and drain the blood or remove the clot. Afterwards, the surgeon will close and the brain.

Brain Tumor

A brain tumor is a mass of abnormal cells in the brain that can be cancerous or noncancerous. It is necessary to remove the brain tumour as it can spread elsewhere in the body.

Surgery for Brain Tumor

Surgery to remove the brain tumor is the most preferred line of treatment. The neurosurgeon will try to remove as much tumor as possible. The location of the tumor determines whether it is possible to remove the brain tumor entirely without harming the surrounding tissue.

  • Minimally Invasive Scarless Brain Surgery is possible for precise removal of the brain tumor with minimal risk of complications. The surgeon performs this surgery in coordination with brain imaging specialists for accurate results.
  • Stereotactic radiosurgery is a highly focused form of radiation treatment that kills tumor cells in the selected area. Neurosurgeons use different radiation technology such as Gamma Knife or linear accelerator to deliver radiation to the brain tumor.

Nerve Irritation

Nerve Irritation refers to muscle twitching or pain experienced by the patient on account of compression of a nerve by another vein or artery.

Surgery for Nerve Irritation

The neurosurgeon performs a Microvascular decompression (MVD) surgery to insert a sponge between the nerve and the compressing vessel for relief from nerve twitching and pain. Microvascular decompression (MVD) surgery brings relief to patients suffering from trigeminal neuralgia, glossopharyngeal neuralgia, or hemifacial spasm.

Damaged Dura Mater

Dura Mater is the thick leathery membrane in the brain. It protects the brain and the spinal cord. Dura Mater gets damaged during brain surgery, tumor ingrowth or severe head injury.

Dura Mater Repair Surgery

The surgeon performs a dura mater repair surgery to resolve the issue. The surgeon repairs Minor dural tears through a microscope, fine needles and clips. In the case of major dural repair, the surgeon will use a patch or a graft harvested from animals or human cadavers. The surgeon has to ensure that the cerebrospinal fluid does not leak into the brain.

Pressure after Head Injury

The swelling in the brain leads to pressure after head injury. This pressure can damage the brain further leading to complications.

Surgeries for Pressure after Head Injury

  • Craniotomy- The surgeon performs a craniotomy i.e. a brain surgery to remove a part of the skull i.e. the bone flap and give required space to the brain and relieve the pressure. This surgery is known as a craniotomy.
  • Craniectomy - Craniectomy is yet another surgery where the neurosurgeon replaces the the removed bone with an artificial one. The patient is required to wear a helmet to protect the brain during this period.

Epilepsy

A patient suffering from epilepsy experiences seizures frequently. It is performed only if anti-seizure medicines fail to control them. The neurosurgeon will suggest surgery if the seizures originate from a single location in the brain. The primary intent of the epilepsy surgery is to sever or cut off the interaction of the affected brain area with the rest of the brain and stop seizures entirely.

Surgery for Epilepsy

The surgeon will assess the patient's condition along with the origin of the seizure in the brain before deciding with surgery to perform. There are various epilepsy surgeries viz. resective surgery, laser interstitial thermal therapy (LITT), deep brain stimulation, corpus callosotomy, hemispherectomy, functional hemispherectomy.

Parkinson's disease

This disease leads to difficulty in moving, balancing and motor coordination in the patients.

Surgery for Parkinson’s disease

Deep brain stimulation (DBS) surgery - The neurosurgeon will advise a Deep brain stimulation (DBS) surgery to reduce dependency on medications and live better. In this surgery, the surgeon implants a neurostimulator to regulate brain activity with the help of electric pulses. After the deep brain stimulation surgery, the tremors, slowness, stiffness, falls and injuries experienced by the patient reduce to a great extent.

Skull Fracture

Skull Fracture refers to break in the skull i.e. the cranial bone. There are two types of severe skull fractures viz. depressed fracture and basal fracture. Depressed fracture is a severe fracture that extends into the brain cavity or indents the skull. Basal fracture occurs around the eyes, ears, nose, top of the neck or near the spine. i.e. at the floor of the skull.

Surgery for Skull fracture

The surgeon will advise Neurosurgery for severe skull fractures while the medication is sufficient to treat minor skull injuries.

Stroke

A stroke condition occurs when there is a blockage that prevents the blood flow in the artery to reach the brain. Clots or plaques in the arteries make them narrow and preventing the smooth flow of the blood. Plaque built up in the carotid arteries in the neck region also leads to the occurrence of the stroke.

Surgery for Brain stroke

There are multiple brain surgery options to treat a stroke patient such as carotid endarterectomy, Intra-arterial thrombolysis, mechanical thrombectomy, carotid angioplasty being the prominent ones amongst the others.

Fluid buildup in the brain

Fluid buildup in the cavities or ventricles of the brain is also known as hydrocephalus. The fluid buildup is due to increased production of fluid or decrease in the absorption or blockages in the ventricular system.

Surgery for Fluid buildup in the brain

The surgeon performs brain surgery to implant a device called to shunt to divert the CSF away from the brain. It performs till the patient lives and works towards maintaining the intracranial pressure.

The surgeon can also perform endoscopic third ventriculostomy using an endoscope with fibre optic to glance at the ventricular network and create a new passage for CSF to flow.

We wish to emphasis on the critical and complex aspects involved in any brain surgery. Hence, choosing an aptly qualified and experienced neurosurgeon to resolve the brain disorder is a matter of key importance and decision making.



Dr. Gurneet Singh Sawhney is one of India’s well trained and finest neurosurgeon in Mumbai with a high success rate. It requires immense patience and dedication to achieve the level of expertise as achieved by Dr. Gurneet.