Brain Procedures

Today, doctors are using computerized technologies that are familiar to us in the consumer world to help them fight cancer in the operating room. An important example of that application is image-guided surgery (IGS) and which helps surgeons perform safer and less invasive procedures and remove brain tumors that were once considered inoperable due to their size and/or location.

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Similar to a car or mobile Global Positioning System (GPS), image-guided surgery systems use cameras or electromagnetic fields to capture and relay the patient’s anatomy and the surgeon’s precise movements in relation to the patient, to computer monitors in the operating room. These sophisticated computerized systems are used before and during surgery to help orient the surgeon with three-dimensional images of the patient’s anatomy including the tumor.

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IGS or neuronavigation supports minimally invasive procedures, improves patient outcome, and preserves neurological function. This, in return, reduces the length of hospitalization, increases patient flow, and reduces the risk of revision surgeries. These are all factors where neuronavigation contributes to the reduction of overall hospital cost.

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Image-guided surgery (IGS) is used to plan and perform surgery minimally invasive, such as a brain tumor removal or a brain biopsy. During a neuronavigation procedure, instrument movement inside the brain can be tracked on the monitor with millimeter accuracy, helping to avoid surrounding healthy tissue and critical areas as much as possible. Countless surgeons have commented and research shows many benefits to IGS:

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• Supports minimally invasive approach

• Pre-operative planning can help increase surgical confidence

• May improve patient outcomes, especially for certain tumors like gliomas

• Improves visualization of the operative field to help avoid critical brain structures

• Pre-operative planning may help preserve important brain function

• Has been shown to improve surgical outcomes for complex surgeries

• May decrease the risk of surgical errors

• May reduce operating, hospitalization and recovery time

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The real-time display of instrument location, orientation, and relationship to nearby structures in the brain has been demonstrated to enhance the confidence of surgeons and their perception of safety.

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Image-guided surgery is designed to help surgeons target the brain tumor with pinpoint accuracy. Accurately locating and removing the brain tumor is important and helps surgeons to preserve the patient’s brain functions after surgery. Studies have shown that functional neuronavigation can improve surgical outcomes for complex surgeries.

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It has been demonstrated that functional neuronavigation improves surgical outcomes, particularly for complex surgeries.

A brain tumor, whether malignant or benign, is a very serious condition that requires prompt and thorough treatment. Even benign tumors of the brain can grow, albeit slowly, and become life-threatening. Primary tumors are those that grow in the brain, while secondary tumors start somewhere else in the body and have now spread or metastasized to the brain. Resection is performed mostly on primary brain tumors, but in some cases, resection of secondary tumors is necessary as well.

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Brain tumor resection removes part or all of a tumor with the goal of not damaging neurological functions. If complete resection cannot be completed, the tumor can recur and continue growing. Although there are risks involved with brain tumor resection, the dangers of an untreated tumor are worse. Resection may be followed by chemotherapy or radiation, especially if the tumor is not completely removed.

Gamma Knife® / Stereotactic Radiosurgery offers a non-invasive alternative treatment method to brain tumor patients who do not wish to undergo the traditional, risky open surgery methods. No surgical incision is made during this procedure. Instead, gamma radiation beams are targeted on the lesion, causing it to slowly dissolve. The beams do not harm surrounding tissue but still transmit a high dose of radiation to the treated tumor.

Gamma Knife® / Stereotactic Radiosurgery offers a safer and less expensive treatment alternative that also comes with a painless procedure and shorter recovery time. It can also often reach tumors that were considered inoperable with traditional surgery.

Hydrocephalus is a neurological condition that causes an enlargement of brain ventricles due to an accumulation of cerebrospinal fluid.

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Hydrocephalus can usually be treated with the placement of a shunt, which is a device that is implanted to drain the cerebrospinal fluid away from the brain and empties in the abdomen where it is absorbed. The shunt can be a traditional fixed pressure or can be programmable to reach the correct pressure for effectiveness. The shunt is implanted during a relatively simple procedure under general anesthesia.

Clipping is a procedure done to prevent a weakened aneurysm from bleeding into the spaces around the brain. An aneurysm is a balloon-like bulge in an artery wall. If an aneurysm bursts, it can be life-threatening. This procedure is performed through traditional open surgery to place a clip on the base of the aneurysm to block normal blood flow. The clip is made of titanium and stays on the artery forever. If an aneurysm has already burst, clipping may be performed as an emergency procedure to prevent further damage.

Arterio-venous malformation (AVM) is a condition that occurs when blood pumps to and from the heart without providing the proper nutrients to the brain. This happens because of an abnormal collection of blood vessels that lack the tiny vessels called capillaries that nourish the tissues.

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AVM can be treated through embolization, which is plugging of the abnormal blood vessels, radiation, surgery, or any combination of these.

A hematoma occurs when a blood vessel within the brain or between the skull and brain ruptures as a result of a traumatic head injury. The hematoma is the collection of blood that is left from this which can compress your brain tissue and be life-threatening.

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A hematoma often needs to be removed surgically. Small amounts of blood can be removed through perforation, creating a small hole through the skull to suction out the blood, while large hematomas may require traditional open surgery, known as craniotomy.

Craniosynostosis is a birth defect in which one or more of the cranial sutures, the joints between the bones of the skull, closes before the brain is done growing. Other areas of the skull continue to grow, forming an abnormal skull shape. If too many sutures close, the brain may not properly develop. Surgery can be performed to relieve pressure on the brain and cranial nerves, as well as give the head an improved symmetry and appearance.

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Hydrocephalus is an accumulation of cerebrospinal fluid (CSF) in the brain that causes enlargement of the ventricles and places pressure on the tissues in the brain. This genetic disorder affects approximately 1 in every 500 children. Treatment usually includes implantation of a shunt system, which directs the excess CSF to another area of the body where it can be naturally absorbed.

Microvascular decompression (MVD) is a surgical procedure that treats trigeminal neuralgia and other painful conditions that involve the compression of cranial nerve roots by veins or arteries. This procedure inserts a tiny sponge in between the nerve root and the vessel that is compressing it, relieving pressure and related symptoms. MVD is highly successful in relieving compression and is often recommended when medication or other conservative methods have failed or produced unwanted side effects. MVD is performed under general anesthesia and requires a short hospital stay.