Relevant answers to your frequent questions...

Brain surgery : Frequently Asked Questions

Brain surgery?

After brain surgery, NCR is very important. The brain is surrounded by connective tissue, such as the meninges, and then by bone. This network of bone and connective tissue is interlocked and integrated. When they are changed, there are great implications for the functioning of the brain and body. The structures of the head are changed dramatically with surgery, and there are usually no efforts to return the head to its normal mechanical function. After brain surgery, many people feel different from before. ...

What is bloodless brain surgery?

Bloodless brain surgery is another term for radiosurgery that involves very precisely targeting hundreds of beams of radiation at a specifically defined target. It therefore can replace conventional surgery.

Is surgery required in brain injury patients?

No, surgery isn’t always required in brain injury patients. In many cases, time is the best healer. However, in cases where surgery is required, such as to remove a blood clot, the long-term prognosis is similar to those cases where surgery wasn’t required.

What makes this brain surgery different?

Many patients have been personally touched or are familiar with someone who has had a craniotomy and believe that paralysis or speech difficulty are the only outcomes from craniotomy. They are frequently unaware or don't realize that an initial, life-threatening cause, such as a cancerous tumor or collection of blood between the layers of membranes covering the brain, leads to that craniotomy. Surgery as a treatment of epilepsy is not usually viewed as life-saving. ...

What type of brain surgery is best for dystonia?

While this field is rapidly evolving, evidence is starting to accumulate that the best brain region for surgery for dystonia is the globus pallidus. This is a peanut-sized structure deep in the brain whose electrical activity is abnormal in dystonia. While the older lesioning technique and the newer DBS technique can both be effective, we usually prefer DBS over lesioning because it is reversible and adjustable, and does not permanently destroy any part of the brain. ...
Evidence is starting to accumulate that the best brain region for surgery for generalized dystonia (dystonia affecting the whole body) is the globus pallidus. This is a peanut-sized structure deep in the brain whose electrical activity is abnormal in dystonia. For dystonias affecting mainly the neck and face, hower, the optimal target is less clear. Although DBS of the globus pallidus often improves the dystonia, there can also be subtle impairments (slowing down) of previously normal limbs with this techniques. ...

What is a typical brain tumor surgery?

There are two main purposes for surgery in patients with brain tumors. The first is to obtain tissue to make a diagnosis. In some cases, tumors can be treated with minimal amounts of surgery. The second goal is to allow the surgeon access to the tumor to attempt total removal. In some cases, this cannot be achieved but reducing the total volume of the tumor will assist with radiation treatments or chemotherapy in treating the tumor. From a technical standpoint, a brain tumor removal operation is called a craniotomy. ...

What about computerized brain surgery? Are you familiar with this?

I believe what you may be referring to is called Image Guided Surgery and is being used increasingly by surgeons in many areas of the body. For the neurosurgeon performing brain tumor operations, this involves placing some markers on the scalp, obtaining a pre-operative CT or MRI image of the brain, and then processing this information in a computer workstation pre-operatively. What this allows the surgeon to do is to study the patient's anatomy in a three dimensional computer model before entering the operating room. ...

What is a craniotomy and is it considered major brain surgery?

A craniotomy is an opening made into the skull to reach the brain for a variety of conditions, including resection and removal of a lesion. It is a major operation associated with significant risks. A craniotomy should not be performed unless the patient's quality of life is significantly affected by seizures and behavioral concerns. All of the patients whom we have treated have been in critical situations. After treatment they improved with various degrees of success.

What can I expect when having brain surgery?

Many brain tumors are treated with surgery. The purpose of surgery is to remove as much of the tumor as possible, establish an exact diagnosis, and provide access to the tumor site for other treatments. Surgery to remove a brain tumor is called a craniotomy. In most cases, the neurosurgeon cuts into the scalp and removes a piece of the skull to expose the area of the brain over the tumor. In some cases, surgeons can reach tumors by entering the skull through the sinus cavities. ...

When is your next sewing/Max/Arduino/brain surgery workshop?

Classes are repeated on a semi-regular basis according to demand. Currently our most popular classes are Arduino, Max/MSP, electronics and sewing. If you are interested in a class email us at machine@machineproject.com and we can place you on a waitlist. This ensures that you’ll be notified first and lets us know when we have enough people to offer a class.

Where can a patient or referring physician find detailed information about brain surgery and brain disorders?

Visit www.brain-aneurysm.com for information about cerebrovascular disorders such as brain aneurysm, arteriovenous malformation, arteriovenous fistula, cavernous malformation (cavernoma), and carotid artery disease. Also visit our www.brain-surgery.us Site for information about brain tumours and traumatic brain injury, and a multitude of other brain disorders, in addition to details of the book Brain Surgery by Dr Khurana. Where can I see images of TCH Neurosurgery? ...

Are there drug therapies? Or is surgery the only solution for brain tumors?

The treatment approach is dependent on determining the correct pathology or tumor type. For certain benign tumors, surgery is likely the best choice. For more aggressive tumors, a combination of radiation and chemotherapy is often utilized. The physician treating patients with brain tumors is continually considering these treatment possibilities in various combinations.

Is it true you had brain surgery and was in a coma and why?

Yes, I had a 10 1/2 hour brain surgery operation and was in a coma for 6 weeks, because of a disease called A.V.M. of the Brain.

Do I have to have my hair cut before brain surgery?

For most patients undergoing brain surgery, some hair is cut in the area of the incision. Rarely, the entire head is shaved. Some neurosurgeons feel comfortable with just combing the hair out of the way and carefully preparing the scalp in the area of the incision. Thus, whether hair is cut depends upon the doctor and what exactly is being done in that specific instance.
Source: www.cpmc.org

Is G amma Knife treatment more or less expensive than traditional brain surgery?

Cost studies have shown Gamma Knife radiosurgery to be less expensive than conventional neurosurgery because it eliminates lengthy post-surgical hospital stays, expensive medication and potentially months of rehabilitation. Importantly, there are virtually no post-surgical disability and convalescent costs with this procedure.

Is Gamma Knife treatment more or less expensive than traditional brain surgery?

Cost-studies have shown Gamma Knife radiosurgery to be less expensive than conventional neurosurgery because it eliminates lengthy post-surgical hospital stays, expensive medication and sometimes months of rehabilitation. Importantly, there are virtually no post-surgical disability and convalescent costs with this procedure. Gamma Knife radiosurgery is reimbursed by most insurance companies, PPOs, HMOs and Medicare.
Cost studies have shown Gamma Knife radiosurgery to be less expensive than conventional neurosurgery because it eliminates lengthy post-surgical hospital stays, expensive medication and potentially months of rehabilitation. Importantly, there are virtually no post-surgical disability and convalescent costs with this procedure.

What is the most commonly used treatment for brain and spinal tumors? Is surgery the first step in both?

That is a good question. The initial step in starting treatment for any tumor is obtaining a correct diagnosis. This applies to brain and spinal tumors as well as tumors anywhere in the body. If the patient is known to have metastatic cancer, it is not always necessary to re-biopsy before initiating other treatment. However, almost always, as an initial step, a portion of tissue will need to be obtained in order to guide appropriate therapy.

Is pregnancy possible for a patient who underwent surgery for deep brain stimulation?

The devices implanted for deep brain stimulation are compatible with a pregnancy. The decision to assume a pregnancy is more influenced by the clinical and genetical context than by the presence of the implanted devices.

Is this procedure the norm in brain surgery, or are there other more traditional means that are more commonly used?

This is one of the standard methods to treat some types of tumors and lesions, although conventional brain surgery is also used commonly for many of these same lesions as well.

What’s the average length of hospitalization and recovery time after brain tumor surgery?

Length of stay and recuperation depend on the type of surgery being performed and the patient’s condition prior to the operation. Generally speaking, however, a routine procedure involving the upper section of the brain may require a three- to four-day hospital stay; when the lower brain is operated on, the stay may be a day or two longer. Patients are encouraged to resume their regular activities as soon as possible; many are back at work within two to three weeks after they are discharged from the hospital.

Why are some brain tumor patients treated with surgery alone, while others also undergo radiation or chemotherapy?

There is no one-size-fits-all treatment for brain tumors. It’s true that some low-grade tumors can be completely removed and cured by surgery. However, high-grade tumors (those that are the most malignant) tend to grow and spread very rapidly. Radiotherapy is used to slow the growth or reduce the size of tumors. While radiation can be delivered conventionally–that is, by using external beams aimed at the tumor–there are other techniques. Brachytherapy refers to radioactive "seeds" that are placed at the tumor site. ...

I heard that surgery for brain tumors and certain brain vessel diseases is now obsolete and one does not need to be operated on. Is this true?

i Because the premise of the question is obviously sweeping, the answer is NO. Surgery remains as the hallmark for treatment for most cases. I can understand the desire and need for an ideal treatment that does not require surgery and yet cures or controls the problem. Despite all advances we still do not have the panacea of miracle cure. However, there's a new development in neurosurgery called Stereotactic Radiosurgery (SRS)which allows a non-invasive approach in treating brain tumors. ...

How can orthopedic surgery help when spasticity, tone and movement difficulties encountered in cerebral palsy are caused by problems in the brain (or CNS)?

Since there are no known ways to operate on the brain to make cerebral palsy (CP) better, orthopedic surgery can help to "rebalance" muscles that are getting inappropriate signals from the brain.
Source: www.hss.edu

Should I put my old dog or cat through brain surgery to have a brain tumor surgically removed?

Unlike humans, most brain tumors of dogs and cats grow from the lining tissue that surrounds the brain and not from the brain itself. Therefore these tumors can generally be removed without causing any brain injury. Brain surgery also causes almost no pain since the brain itself does not have any pain sensitive nerve endings. Most dogs and cats that have brain surgery are awake, standing, walking and eating within a few hours after surgery and go home the next day. ...

My husband has a small tumor on his brain which his doctor said must be removed. The thought of brain surgery is frightening to us both. Can you give us any encouragement?

Yes, new technology has made it possible for neurosurgeons to plan and rehearse an operation before it takes place. Doctors can plan their strategy on a computer monitor; and if any problems are revealed, changes in the plan can be made. Tumors, aneurysms, epilepsy and arteriovenous malformations now can be treated more precisely than ever before. Some disorders previously considered inoperable, including abnormalities deep inside the brain, are now treatable with the help of this technology. ...

I had surgery three months ago to remove a tumor on the right side of my brain. Now I am taking tegrotal for seizures. Will exercising cause a seizure?

Of course, any comments I can make are only general suggestions, and you will need to check with your doctor for specifics. However, in my patients, it is very common to utilize tegrotal or other similar medications to prevent seizures. Sometimes indefinitely, depending on how concerned I am with the particular location. I do not generally recommend that my patients stop exercising or participating in exercise related activities. ...
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