Brain surgery

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Before and after hematoma repair

Brain surgery is a procedure to treat problems in the brain and the surrounding structures.

Craniotomy; Surgery - brain; Neurosurgery; Craniectomy; Stereotactic craniotomy; Stereotactic brain biopsy; Endoscopic craniotomy

Before surgery, the hair on part of the scalp is shaved, and the area is cleaned. The doctor makes a surgical cut through the scalp. The location of this cut depends on where the problem in the brain is located.

The surgeon creates a hole in the skull and removes a piece, called a bone flap.

If possible, the surgeon will make a smaller hole and insert a tube with a light and camera on the end. This is called an endoscope. The surgery will be done with tools placed through the endoscope. MRI or CT can help guide the doctor to the proper place in the brain.

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During surgery, your surgeon may:

• Clip off an aneurysm to prevent blood flow
• Remove a tumor or a piece of tumor for a biopsy
• Remove abnormal brain tissue
• Drain blood or an infection

The bone flap is usually replaced after surgery, using small metal plates, sutures, or wires. The bone flap may not be put back if your surgery involved a tumor or an infection, or if the brain was swollen. (This is called a craniectomy.)

The time it takes for the surgery depends on the problem being treated.

Brain surgery may be done if you have:

• Brain tumor
• Bleeding (hemorrhage) in the brain
• Blood clots (hematomas) in the brain
• Weaknesses in blood vessels (See: Brain aneurysm repair)
• Abnormal blood vessels in the brain (arteriovenous malformations; AVM)
• Damage to tissues covering the brain (dura)
• Infections in the brain (brain abscesses)
• Severe nerve or face pain (such as trigeminal neuralgia or tic douloureux)
• Skull fracture
• Pressure in the brain after an injury or stroke
• Epilepsy
• Certain brain diseases (such as Parkinson’s disease) that may be helped with an implanted electronic device

Your doctor will examine you, and may order laboratory and x-ray tests.