Narayana Health Care

What is head surgery & brain surgery?

Brain surgery is an umbrella term used to refer to various types of medical procedures that involve repairing certain structural defects of the brain. Head & brain surgery is an extremely complicated process and the procedure depends on the type of condition being treated.

Why is head surgery performed?

Whether or not to undergo an open brain surgery depends on how critical the condition of the patient is. Often, less critical diseases or abnormalities can pose a serious life risk because of its side-effects. In such cases, the head operation needs to be performed to correct the physical deformities of the brain and the surrounding structures.

Types of head surgery:

Depending on the part of the brain and the condition being treated, there can be several types of head surgery. Let us discuss the different head operation procedures that are performed by trained surgeons.

1. Craniotomy

A craniotomy is one of the most common procedures of brain surgery. In this case, doctors perform a skull surgery by making an incision on the skull near the affected area of the brain. This creates a hole in the skull called the bone flap. A craniotomy is done in the following cases:

• Removal of brain tumors
• Snipping off a brain aneurysm
• Drain accumulated blood and fluid from a brain infection
• Removal of defective brain tissues

After the procedure is done, the bone flap is closed with the help of wires, sutures or plates.

2. Craniectomy

Similar to a craniotomy, this type of brain surgery may be done in conditions of brain tumors, swelling or infections. In this case, the bone flap is left open.

3. Biopsy

A small incision or hole in the skull is created to remove a small amount of brain tissue from the defective area in order to study it better under the microscope.

4. Endonasal Endoscopic Surgery

One of the minimally invasive types of head surgery involves the insertion of an endoscope – a telescopic device fitted with lights and a camera through the nose and sinuses. This process does not require any incision to be made. Endoscopic Surgery is performed to remove tumors from the pituitary gland and the base of the skull.

5. Neuroendoscopy

A type of skull surgery, the surgeon makes small holes in the skull to reach to the defective parts of the brain, mainly to remove tumors.

6. Deep Brain Stimulation

This head operation procedure involves making incisions or a small hole at the skull to insert a small electrode inside the brain. This device is connected to a battery in the chest that sends electrical signals to the brain. Deep brain stimulation is done in patients who show symptoms of brain disorders such as Parkinson’s disease.

Conditions that require head surgery:

The following conditions in and around the head may demand brain surgery:

• Presence of a brain tumor
• Hemorrhage – Bleeding in the brain
• Hematomas – Blood clots in the brain
• Brain aneurysm – Weakness in blood vessels
• Arteriovenous malformations – Abnormal blood vessels
• Brain abscesses – Infections in the brain
• Hydrocephalus – Swelling of the brain
• Damage to the protective tissue (dura) covering the brain
• Brain diseases that require the implantation of an electronic device
• Post-injury or stroke pressure in the brain
• Nerve damage or irritation
• Skull fracture
• Epilepsy

Risks involved in the procedure:

Head surgery is one of the most critical medical procedures and hence, there are many risks, mild to life-threatening that come along with it. Some of them are:

• Bleeding
• Impairment of speech, vision, and balance
• Infection in and around the wounded site
• Swelling of the brain
• Memory loss
• Seizures
• Brain Stroke
• Coma

Outlook and Prognosis:

How well patients do after the head operation depends on the types of head surgery performed and the general health of the patient. Most of the patients who have undergone skull surgery nowadays will be back to their work within 10-12 days in the same way patients undergoing major surgeries may take 2-4 weeks for recovery and patients might suffer from headaches or have problems concentrating. Some of them may also require physical therapy or rehabilitation.

Head Surgery FAQs:

• How many hours does a head/brain surgery take?

Depending on the severity of the brain condition and the type of head surgery, the procedure may take 2-12 hours.

• What is the recovery period of brain surgery?

Patients may need to stay in the hospital under observation for at least 3-10 days post-surgery. Complete healing might take almost 6-12 months.

Dr. Bhanu Chandra, Consultant – Neurosurgery | HSR Bangalore