The choice of treatment for a brain tumour merely depends on the following. Thus, the below mentioned can also be considered as the steps that will be followed prior to a brain tumour surgery.
- Detection of the type and grade of brain tumour
- Detection of its site in the brain
- Detection of its size
Post analyzing the above, the age and the general health of the patient is reviewed. Moreover, if the patient is already on any medication, the decision of the surgery will also depend on the same.
The doctor shall guide the patient with all sorts of instructions before proceeding with any of the brain tumour surgery.
The procedure defers by the type of brain tumour a patient is experiencing. However, following are the different types of brain tumour treatment procedures. During each of these procedures either the patient is asleep or heavily sedated.
- Biopsy: This surgical process involves removal of a sample of tumour tissue.
- Craniotomy: This surgical process involves the elimination of a part of the skull. Through this process, the neurosurgeon finds the tumour and removes it as much as possible. The part of the skull is removed during the procedure is then replaced after the surgery.
- Craniectomy: This procedure is very much similar to craniotomy. The actual difference in this procedure is that the portion of the skull that is removed is not replaced at the end.
- Debulking: This process involves the reduction of the size of tumour surgically.
- Partial Removal: In this procedure, only a part of the tumour is removed surgically because of the risk of neurological damage.
- Complete Removal: In this process, the entire tumour is surgically removed. Often, in this case, depending on the type of tumour, the surgeon can let the patient know if the re-growth is likely to take place or not.
- Shunt: The shunt procedure involves the insertion of a drainage system which is designed to transfer excess fluid from the brain to some other part of the body.
- Ommaya Reservoir: This surgical process takes place by inserting a small container attached to a tube beneath the scalp. This particular container can be used for either delivering chemotherapy treatment to the brain and the surrounding (CSF) cerebrospinal fluid, or removing CSF for detecting the existence of normal cells, or for removing cystic fluid and eliminating the need for surgery.
- Skull Base Surgery: This surgery refers to a specialized technique for both locating the tumour as well as its removal in the detected area.
- Transsphenoidal Surgery: This type of surgery is mostly implied in the cases of pituitary adenomas and craniopharyngiomas.
- Laser Interstitial Thermal Therapy (LITT): This therapy is one of the most minimally invasive methods of ablating (cooking) a particular tissue with heat. It is considered to be an effective as well as a safe technique of ablating not only poorly accessible tumours, but also for new or recurrent metastatic and primary tumours anywhere in the brain.
- The patient is most likely to wake up in the recovery unit of the OT, in an ICU or HDU (High Dependency Recovery Unit)
- Neurological observations will be done by the nurse.
- An oxygen mask would have been placed on the patient, and several tubes might also be connected. This might be a bit disturbing but is all done to help the patient recover smoothly.
- A dressing will be visible at the site of operation.
- The patient might feel a headache for which he/she shall be provided with painkillers to help in relaxing.
- When the patient is fully awake, the nurse provides him/her water to observe closely if there is any problem in swallowing.
- Getting up and moving around for the patient will be very difficult, but doing so very gradually and as per the doctor’s instruction will help in reducing the risk of blood clots in the legs.
A list of instruction will be provided to the patient by the doctor, which will have to be followed very strictly. Moreover, medication will be given to recover swiftly. If any discomfort is faced by the patient, the same should be immediately informed to the doctor.
General risks include:
- Blood pressure instability
- Blood clots
Specific risks that a brain tumour surgery might lead to include:
- Balance/coordination difficulties
- Memory or cognitive problems
- Excess fluid in the brain
- Spinal fluid leakage
- Brain swelling