Neurosurgeons perform brain surgery for a variety of medical reasons, including brain tumors, epilepsy, vascular malformations and traumas. Brain surgeries have been performed for thousands of years and typically required removal of a portion of the skull brain to access the brain. Removal of a portion of the skull is still a common method of brain surgery, but with some of the new techniques that are available, some brain surgery may be minimally invasive procedures.
Endovascular Surgery
Some patients have disorders of the blood vessels of the brain such as aneurysms or arteriovenous malformations. These lesions can burst, causing bleeding in the brain. A type of brain surgery called endovascular surgery can be used to treat these blood vessel lesions, according to the Washington Brain & Spine Institute website. Endovascular surgery is not an open procedure--meaning that a piece of the skull does not need to be removed--and the neurosurgeons and the neuroradiologists work together during this type of surgery. The doctors reach the abnormal blood vessels in the brain through a blood vessel like the femoral artery in the thigh; platinum coils are threaded into the lesion, which prevents rupture and bleeding, as noted on the Brain Aneurysm website. Endovascular surgery does not work for all vascular lesions, and open brain surgery may be required.
Radiosurgery
According to the International RadioSurgery Association website, stereotactic radiosurgery can be used to treat disorders of the brain using high-dose radiation directed at the abnormal tissue. This treatment can be used for brain tumors because the radiation damages the tumor cells and stops their growth and reproduction; radiosurgery can also be used for abnormal blood vessels because the radiation causes the blood vessels to close off and clot, preventing any bleeding. Radiosurgery does not involve any cutting of the skin; however, there are still some potential side effects from the radiation like swelling and the formation of a clump of dead cells called necrosis, which might require removal.
Endonasal Endoscopy
In an endonasal endoscopy procedure, neurosurgeons and otolaryngologists or ear, nose and throat doctors work together to remove tumors through the nose and sinuses without cutting open the skin, according to the Johns Hopkins Medicine website. An endoscope uses a video camera and a bright light; the surgeons guide this device through the nose and sinuses to the area of concern in the brain. Small scissors and forceps can be inserted through the end of the endoscope to remove the abnormal tissue or repair the lesion. Endonasal endoscopy has a shorter recovery time than open surgery, and there is less damage to the brain.
Craniotomy
During a craniotomy, a portion of the skull is removed according to the Johns Hopkins Medicine website. The location of the skull that is removed varies depending on the procedure--for surgeries at the front of the brain, the skull above the eyebrow may be removed and for surgeries at the base of the brain, a small piece of skull may be removed. Brain mapping may also be done during a craniotomy where the surgeons map out different parts of the brain so that the parts that control certain functions can be avoided during the procedure. The patient may have to be awakened during the procedure so that the doctors can perform the tests.
