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Surgery for Brain Tumours

What is neurosurgery?

Neurosurgery is an operation led by a neurosurgeon. This is usually the first step in the treatment for most types of brain tumours.

The goal is to remove as much of the tumour as possible whilst avoiding any damage to parts of the brain that control important neurological functions.

This type of neurosurgery is often called a resection, and can be full (when all visible tumour is completely removed) or partial.

What does debulking or partial resection mean?

Unfortunately, it is not always possible to completely remove a brain tumour. This is sometimes called a ‘partial resection’, meaning that part of the tumour has to be left in place. In such cases, the neurosurgeon will aim to reduce the size (bulk) of the tumour as much as possible in a process known as ‘debulking’.

What is an inoperable brain tumour?

An inoperable brain tumour is one that cannot be operated on: meaning that it cannot be removed by neurosurgery. The risks of brain surgery are usually considered to be too high for one or more of the following reasons:

  • The tumour is in a position or part of the brain that it is very difficult or impossible to reach in surgery without damaging other healthy parts of the brain, risking severe side effects affecting crucial bodily functions
  • The tumour is near a blood vessel that may be damaged and therefore the risk of stroke or haemorrhage (bleeding in the brain) is considered too high

What is an awake craniotomy?

An awake craniotomy is an operation in which the patient is given a general anaesthetic so that they are completely unconscious whilst the neurosurgeon gains access to the brain through the skull. 

Once the neurosurgeon is ready to operate on the tumour, the patient is woken up and asked to perform simple tasks such as speaking, moving their hands, feet and other basic neurological tests.

Through sophisticated scanning techniques that happen live during the operation, the neurosurgeon can see which parts of the brain are controlling these vital functions and can avoid those areas.

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What is a ventriculoperitoneal shunt?

A ventriculoperitoneal (VP) shunt may be placed in the head during surgery, in order to drain excess fluid from inside the brain thereby helping to control the pressure inside the brain.

The VP shunt is a tube connected from the ventricles of the brain into the abdominal cavity, heart or large veins of the neck.

Page last updated in January 2019. Next review September 2019.

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