Brain tumor surgery
Overview
Brain tumor surgery is a procedure to remove a mass of unhealthy cells in the brain. A tumor may be cancerous, also called malignant, or noncancerous, also called benign. Brain tumor surgery may be the first treatment for a brain tumor. Some people only may need surgery to remove the tumor. Others may have more treatments such as radiation therapy or chemotherapy medicines.
The goal of brain tumor surgery is to remove the entire tumor without damaging the healthy brain tissue around it. Sometimes, surgeons may only be able to remove part of the tumor.
There are several types of brain tumor surgery:
Why it's done
Brain tumor surgery can be done for many reasons, including to:
Risks
The risks of brain tumor surgery depend on the type of surgery that you have. Craniotomy, for example, is an invasive surgery that carries more-significant risks than does a noninvasive procedure such as transsphenoidal surgery or stereotactic radiosurgery, also called Gamma Knife surgery.
The risks also depend on the size and type of the tumor, where it is in the brain, and your overall health.
Some common risks of brain tumor surgery include:
A significant risk of brain tumor surgery is damage to the nearby areas of the brain that control basic functioning. This damage may cause changes in speech, balance or movement. Rare but serious risks of brain tumor surgery include coma, stroke and death.
For stereotactic radiosurgery, possible risks include:
All types of surgery have similar basic risks. These can include:
How you prepare
You and your healthcare team discuss how to prepare for brain tumor surgery. You'll likely need to have a physical exam and testing and take some precautions to prepare your body.
Tests before brain tumor surgery may include:
Brain imaging, such as MRI or CT scans. These tests take pictures of the inside of your brain. They can help your healthcare team plan your brain tumor surgery. The images can determine the size and location of your tumor. You may have a contrast material injected through a needle placed in a vein in your arm, called an IV. The contrast material helps the tumor show up more clearly in the scans.
You may have a special type of MRI called a functional MRI (fMRI) before brain tumor surgery. An fMRI shows small changes in blood flow when you use certain areas of your brain. This can help the surgeon avoid areas of the brain that control functions such as speech or moving your arms or legs.
Your healthcare team talks with you about whether you need to stop taking certain medicines before brain tumor surgery. You also might be prescribed a medicine to take before surgery. Your care team also tell you what you can eat or drink before brain tumor surgery.
Before surgery, tell your healthcare team about any medicines you take or any allergies you have to medicines. Include medicines that need a prescription and medicines you buy without a prescription. Also tell the care team about vitamins, herbal products and other supplements you take.
Follow the instructions from your healthcare team about when to stop eating and drinking before surgery.
What you can expect
How you prepare before brain tumor surgery depends on the type of surgery you have. If you're having a craniotomy, you may have some of your hair clipped along your incision. For other types of brain tumor surgery, you may be fitted for a headframe.
Usually, you lie on your back for brain tumor surgery. But you may be on your stomach, on your side or in a seated position.
You may be given a special medicine by mouth before surgery that makes the tumor become fluorescent under the right light. This change makes the tumor easier for the surgeon to see.
You may have medicine that puts you into a sleeplike state for the surgery. This is called a general anesthetic.
You may have awake brain tumor surgery if your surgeon needs to check brain functions such as movement and speech during the surgery. This helps the surgeon avoid damaging the particularly important areas of the brain.
With awake surgery, you may be in a sleeplike state for part of the surgery and then awake for another part of the surgery. You have a numbing medicine applied to the area of the brain that's being operated on so that you don't feel any pain. You're also given a medicine to help you feel relaxed.
The steps involved in brain tumor surgery depend on what type of surgery you are having. For most types of brain tumor surgery, you get medicine through a needle placed in a vein in your arm. This medicine puts you into a sleeplike state so that you are not awake or aware during your surgery and you won't feel any pain.
Your surgeon may use imaging, such as CT or MRI, during brain tumor surgery as a guide.
You will likely lie on a table for your procedure. The position that you are in depends on the location of your tumor and the type of surgery you are having.
If you are having a craniotomy, the surgeon makes a cut in the scalp and removes a small piece of the skull. For a less invasive surgery, the surgeon may only make a small hole in the skull. Once the tumor is removed, the piece of bone is reattached to the skull with small plates and screws.
In an endoscopic brain tumor surgery, the surgeon inserts the endoscope into the hole in the skull. The light and camera on the endoscope help the surgeon see inside the brain to locate the tumor. Then, special tiny instruments are inserted into the hole with the endoscope to remove the tumor. If you're having laser ablation brain tumor surgery, the laser burns the tumor and destroys it. If you're having a biopsy, the tiny instruments remove a small sample of the tissue.
If you are having awake craniotomy, you may be asked to answer questions during your surgery.
If you are having brain stereotactic radiosurgery, you remain awake during the procedure. Since this surgery is painless and no cut is made, you won't have pain medicine. You may have a medicine to help you relax if you feel nervous. Your healthcare team places a headframe on your head and attaches it with four pins. This helps keep your head still and guides the radiation beams during the procedure. Then, strong beams of radiation are pointed directly at the tumor to destroy it.
Right after brain tumor surgery, you go to a recovery room. You'll likely be in a special recovery unit for people who have had brain surgery. You'll still be hooked up to machines that monitor your breathing, heart rate and other vital signs. You may have a bandage over your head if the surgeon had to make a cut. You will likely have a needle in a vein in your hand or arm, called an IV, to deliver fluids and medicines. You may have a drain placed in your skull to allow extra fluid to flow out.
You have medicines to help you manage your pain. You may get other medicines to help reduce your risk of infection, manage swelling or prevent seizures. Your healthcare team watches you during recovery to look for complications such as bleeding, seizures or infection.
You get up and walk around as soon as possible after brain tumor surgery, usually the same day or the next day.
You may have an imaging test, such as a brain MRI or brain CT, to check for swelling and other concerns after surgery.
You will likely need to stay in the hospital for a while after your surgery. How long depends on the type of surgery you had and how well you are recovering. Hospital stays can range from a few days to a week.
Once you can go home, it may take several weeks of rest before you can get back to your typical daily activities. Avoid lifting heavy things and doing vigorous exercises and activities.
If you have a wound from the surgery, your healthcare professional shows you how to take care of it and tells you about any signs of infection to watch for.
You may need rehabilitative therapy after brain tumor surgery to help your body get back to its previous strength and function. Therapy can include physical therapy or speech therapy.
Results
Results of brain tumor surgery depend on the goals and reason for the surgery. Results can include:
You may need additional treatment after brain tumor surgery. This may include chemotherapy or radiation therapy to destroy any remaining cancer cells.
Prognosis depends on the type and stage of tumor and other factors such as your age and overall health. Noncancerous tumors, also called benign tumors, usually have a very good prognosis after brain tumor surgery. The prognosis for malignant or cancerous tumors varies widely.
Updated on Jun 11, 2025
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