When people describe a job that’s not difficult, they sometimes contrast it with one of two tasks considered the most challenging in the world: rocket science or brain surgery. With millions of brain surgeries occurring each year, you’re more likely to require the services of a brain surgeon than a rocket scientist.
Is brain surgery a serious and delicate procedure that presents risks? Yes, but thanks to advances in technology and medicine, as well as the skills and training of today’s neurosurgeons and their surgical teams, 21st-century brain surgery can provide safe, reliable treatment for a wide range of neurological conditions.
The Brain and Its Role
The brain may appear as if it’s a single organ, but as the most complex area of your body, it consists of many parts — including billions of nerve cells, called neurons — working together to control some of the most important functions of the body, including:
- Thinking
- Movement
- Memory
- Breathing
- Behavior
- Your five senses (hearing, taste, sight, touch, smell)
The brain also sends messages throughout your body through a network of nerves (the nervous system) that extends from your brain through your spinal cord down your backbone.
Conditions Requiring Brain Surgery
Not only are there many parts that make up the brain, there are many conditions that can affect those parts. Some of these conditions are common and don’t require surgery (or really any treatment at all) but can become serious enough that surgery is an option.
These conditions include:
- Injury: If you hit your head from an accident, fall, or other kind of contact, your brain can be damaged, causing changes in mood or mental function. This injury is usually called a traumatic brain injury (TBI), and a concussion is a kind of TBI that causes the head and brain to move back and forth rapidly, adding extra pressure on the brain.
- Abscess: This is a pus-filled infection in the brain that may require surgical drainage.
- Aneurysm: A weakened part of an artery may start to swell with blood. This can occur in any artery of your body, but if it occurs in the brain and bursts (ruptures), it can cause bleeding in the brain (hematoma) or a stroke. (See those conditions below.)
- Cancer (and noncancerous tumors): There are several kinds of tumors that can appear inside the brain. If the tumor cells grow uncontrollably and spread to other parts of the body, the tumor is considered malignant or cancerous. But even a noncancerous (or benign) tumor can be problematic and potentially cause symptoms.. Surgery is often a treatment option.
- Encephalitis: This is an inflammation of brain tissue that causes the brain to swell.
- Epilepsy: This is a condition that causes seizures. Surgery can help determine the cause, and provide treatment to reduce the frequency of those seizures.
- Headache: If your headache is extremely painful and constant, and it’s related to an irritated nerve, surgery could provide relief.
- Hematoma: This term means any bleeding outside the blood vessels; a bruise (a “black and blue” mark) you can see on your skin is an example. Inside the brain, a hematoma is a very serious condition that can occur in different areas of the brain due to a variety of causes. Brain hematomas can put pressure on the brain and can cause unconsciousness or death.
- Hydrocephalus: This is when cerebrospinal fluid (CSF) builds up in the hollow places inside the brain (ventricles), increasing pressure on the brain.
- Nerve disorders: There are many conditions related to nerve degeneration (when nerves slowly or suddenly stop functioning). These conditions can be inherited (genetic) or have no known cause, or they may be caused by injury or a tumor, or behaviors such as alcoholism. These conditions affect different parts of your brain function, and include Alzheimer’s disease, amyotrophic lateral sclerosis (ALS, or Lou Gehrig’s disease), Huntington’s disease, and Parkinson’s disease.
- Stroke: This happens when the brain’s blood supply is interrupted or reduced. The cells in the brain tissue that don’t receive oxygen and nutrients can die quickly.
Types of Brain Surgery
Brain surgery can be performed several different ways, based on the condition being treated. These approaches include:
- Biopsy: A sample of abnormal brain tissue is removed with an incision or a needle, and then examined by a pathologist.
- Craniotomy: A piece of the skull is temporarily removed so the surgeon can access the brain to treat conditions including tumors, blood clots, and elevated pressure.
- Deep brain stimulation (DBS): A treatment for movement disorders, electrodes are implanted into certain brain areas to generate electrical impulses that control abnormal brain activity.
- Endoscopy: This technique involves threading an endoscope — a thin tube with a light and camera on the end, and through which tools are used — through the mouth, nose, or small incisions in the skull to access or remove brain tissue.
- Posterior fossa decompression: This a treatment for a Chiari malformation, when part of the brain at the back of the skull bulges through a normal opening where the joins the spinal canal putting pressure on parts of the brain and spinal cord. The surgeon removes a small section of bone in the back of the skull, relieving pressure by giving the brain more room.
- Thrombectomy and cerebral aneurysm repair: The surgeon guides surgical instruments such as a catheter or thin wires through a large blood vessel in the patient’s groin to reach the brain vessels, using contrast dye to identify the problematic blood vessel without opening up the skull. The procedure is most commonly used on patients with a blood clot in a brain artery, a cerebral aneurysm (a weakened and bulging area in an artery wall) or a ruptured aneurysm that causes bleeding into the brain.
Risks of Brain Surgery
As is the case with any surgery, brain surgery — while safer than ever — still has risks. Your surgeon will discuss whether you are a candidate for brain surgery (based on several factors related to your condition, age, and medical history) and potential risks of the specific procedure.
Contact M. Neil Woodall, MD, Today
Should you require brain surgery, having a skilled surgeon to lead the procedure is critical. Dr. Woodall’s skill and experience — and quality of overall care — ensure you can receive the safe treatment you require for your brain condition. Contact our office today.