The procedures and surgical techniques that tackle problems inside your skull

WORDS SCOTT DUTFIELD

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Brain surgery encompasses a myriad of procedures designed to treat an equally diverse set of conditions and associated symptoms, including tumours, blood clots, epilepsy and aneurysms. Neurosurgeries can range from minimally invasive procedures such as a biopsy, whereby a needle is inserted into the brain to collect cells for analysis, to extensive operations that expose the brain to treat blood clots and for tumour removal. Like any other tumour, a brain tumour is an abnormal mass of cells and tissue that wedges itself somewhere in the brain. There are two categories of tumour: benign and malignant. While benign tumours can grow large, albeit slowly, they don’t typically invade surrounding tissue or spread around the body. A malignant tumour, on the other hand, grows much faster, invades other tissue and can spread around the body. All in all, 120 different types of tumour can form in the brain alone.

For both benign and malignant brain tumours, a common course of intervention is a craniotomy and resection, whereby a surgeon removes a portion of the skull to expose the brain and hopefully cut away the tumour. To help guide them through the brain and keep tabs on where surgical instruments are during operations, surgeons use neuronavigation systems that are connected to their equipment. “One of the biggest challenges is distinguishing between normal brain tissue and tumour tissue, which requires extensive training and experience,” says Pietro D’Urso, a consultant neurosurgeon at Salford Royal Hospital in Manchester. “The location of the tumour is another big challenge, particularly if a tumour is in very important parts of the brain, called ‘eloquent areas’, that control speech and motor functions.”