If a brain tumor is located in an accessible and procedurally safe area, brain tumor surgery is often the primary treatment used for removal. Craniotomy, or removal of a portion of the skull, is the main protocol for brain tumor removal.
Radiosurgery, despite its name, does not involve traditional surgical practices. Rather, beams of external radiation provide the energy to destroy tumor cells.
The goal of brain tumor surgery is complete brain tumor removal without disrupting the surrounding brain tissue. If some cells are hidden and not excised during surgery, tumor recurrence is possible. Research suggests that removing at least 90 percent of brain tumor cells leads to a better prognosis, so it's important to remove as much of the tumor as possible. If a tumor has invaded surrounding tissue or has a steady blood supply, the procedure can be more difficult or incomplete.
To prepare for brain tumor surgery, patients over 40 years of age often have a chest x-ray and an electrocardiogram (EKG) to determine their health status and evaluate if brain surgery is an option. Patients of all ages, however, need to be in good health to withstand the stresses of brain surgery.
During a craniotomy, a portion of the skull is removed to provide access to the tumor. While the patient is under general anesthesia, the neurosurgeon will follow a specific procedure:
Although craniotomy is the treatment of choice for brain tumor removal, it is associated with some possible complications, including:
In cases of stereotactic radiosurgery, brain tissue is not cut out as it is during a craniotomy. During this procedure, a computer determines the exact location of the tumor, and assists the surgeon in aiming beams of radiation at brain cells in a very precise fashion.
The person may be fitted with a head frame that has an MRI (magnetic resonance imaging) scanner attached to it, in order to determine the exact location of the tumor. As stereotactic radiosurgery methods evolve, surgeons are often using several radiation beams to target the cells from different angles rather than using the head frame. Machines that perform stereotactic radiosurgery include:
Radiosurgery is generally administered in one treatment and can have side effects, such as:
Complete, regularly monitored recovery after brain tumor surgery or radiosurgery is a very important, and sometimes difficult, part of treatment.
Patients may suffer from headaches and feel tired and weak for several days after a craniotomy. Patients may even experience personality changes or neurological problems if any healthy brain tissue was damaged during brain tumor surgery. Depending on the location and type of the tumor, rehabilitation may require several different types of therapy.
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Mayo Clinic Staff. (2008). Brain tumor. Retrieved April 11, 2010, from the Mayo Clinic website: http://www.mayoclinic.com/health/brain-tumor/DS00281/DSECTION=treatments-and-drugs.
MedicineNet Staff. (n.d.). Brain tumor. Retrieved April 11, 2010, from the MedicineNet.com website: http://www.medicinenet.com/brain_tumor/page7.htm.
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