Brain surgery is used to treat injuries and other problems in the brain or surrounding area inside the cranium. It can be a risky procedure, so it is usually only done when no other course of treatment is available. The most common types of injuries treated with brain surgery are those that create pressure inside the skull, those that cause swelling in the brain, and those that leave foreign matter inside the cranium.
Head injuries that cause a fluid buildup in the skull can put excess pressure on the brain tissue, which can damage the tissue and lead to severe brain injury, long-term disability, or death. The excess fluid build-up is diagnosed through imaging scans and a physical exam of the patient’s pupils. During brain surgery to control pressure, the surgeon drills a burr hole through the cranium and implants a device used to either monitor the or drain the excess fluid.
Swelling in the brain as a result from injury or infectious diseases, such as meningitis or toxoplasmosis, can cause the same complications as pressure from fluid buildup. Swelling is the body’s natural response to injury and, in other parts of the body, serves an important purpose in protecting the injured tissue. Inside the skull, however, there is very little room in which the tissue can expand, and if the swelling becomes too severe, the brain can push against the inside surface of the skull. Brain surgery to alleviate swelling may involve removing part of the skull to give the brain room to expand. The removed portion of the skull may be frozen or implanted under the skin of the abdomen until it is needed.
Certain injuries, such as those involving a significant amount of force against the head, can cause bits of bone, blood clots, and other foreign matter to become lodged in the brain and damage the membrane surrounding the organ. Brain surgery is often performed to remove the foreign matter and repair the damage. This type of surgery may require the installation of temporary metal plates to hold the removed section of bone in place while it mends.
Brain tumors may also be removed through brain surgery, depending on the size and location of the tumor. In many cases, surgery alone is enough to treat a benign tumor. In cases of malignant tumors, radiation, chemotherapy, and medications are often used in conjunction with the surgery.
Risks of brain surgery include excessive bleeding in the brain, coma, seizures and stroke. Depending on the area of the surgery, problems with speech, balance, vision, memory, and other functions can occur. In some cases, these problems are permanent, in others they resolve once the brain has had time to heal. Surgeons will weigh all the potential risks against the benefits before deciding if brain surgery is the best course of action.
