Brain surgery

The brain controls and coordinates conscious and unconscious body functions, as well as ‘higher’ functions such as memory, learning and thinking. Like any other part of the body, it is susceptible to bleeding, infection, trauma and other forms of damage. This damage or alteration in brain function sometimes requires brain surgery (neurosurgery) to diagnose or treat these problems.

Symptoms
The symptoms of conditions requiring brain surgery may vary, depending on the type and severity of the condition. General symptoms include:

• Headache
• Nausea
• Vomiting
• Drowsiness
• Seizures.

• Alterations of the brain tissue - such as brain cancer, infections and swelling (oedema).
• Alterations in brain blood flow - such as subdural haematoma, subarachnoid haemorrhage and intraventricular bleed.
• Alteration in cerebrospinal fluid - such as infection or hydrocephalus.

• Gliomas - glial cells make up the supportive tissue of the brain, and don’t conduct electrical impulses. Glioma is a broad term used to describe brain tumours associated with the three types of glial cell, which include the astrocyte, oligodendrocyte and the ependymal cell.
• Pituitary tumour - cancer of the pituitary gland, such as craniopharyngioma.
• Acoustic neuroma or schwannoma - a type of benign tumour that grows in the canal connecting the brain to the inner ear.
• Medulloblastoma - a type of cancer that originates in the brain and can migrate down the spinal cord.
• Dysembryoplastic neuroepithelial tumour (DNET) - an abnormal tissue growth in the brain that may or may not be cancerous.
• Primitive neuroectodermal tumour (PNET) - a general term referring to abnormal tissue growths of the brain.
• Lymphomas - cancers of the lymphatic system.
• Chordomas - tumours that originate in particular parts of the skeleton including the skull.
• Metastases or secondary tumours - metastasis means cells (usually cancer), which have moved from one part of the body to another.

• Subdural haematoma - the build-up of blood beneath the thickest membrane (meninges) that covers the brain, called the dura mater. A subdural haematoma can be classified as acute, acute on chronic or chronic. The most common cause is head injury.
• Stroke - occurs when a blood vessel supplying the brain either blocks or bursts. A stroke produces sudden and unexpected brain injury and can sometimes be fatal.
• Subarachnoid haemorrhage - bleeding between the arachnoid membrane and the delicate membrane that covers the brain (pia mater). Common causes include head injury and aneurysms.
• Intraventricular bleed - an increase in blood flow may cause the small blood vessels of the brain (periventricular capillary network) to burst. Premature babies are at increased risk.

• Hydrocephalus - the abnormal build-up of cerebrospinal fluid within the skull. In babies, this can cause the head to enlarge.
• Infection - various infections of the brain can cause alterations to cerebrospinal fluid.

• Physical examination
• Medical history
• CT scan
• MRI scan.

• Your doctor
• Neurologist
• Neurosurgeon

• Conditions that require brain surgery include brain cancer, stroke and hydrocephalus.
• If left untreated, any condition requiring brain surgery can cause further damage to the brain.
• A craniotomy is an operation to open the skull in order to access the brain for surgical repair.

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