Brain Surgery: How to Prepare and What Risks are Involved

If brain surgery turns out to be a must for you, your doctor will provide you with complete instructions on how you should prepare for this procedure. You should tell your doctor about any medication you are taking, including nutritional supplements and over-the-counter medicine. Your doctor may ask you to stop taking those medicines in the days before the surgery. In case you had some prior surgeries or allergies or if you have been consuming a lot of alcohol, you should share that with your doctor. Your doctor may give you a special soap to wash your hair with before the surgery happens.

Risks Involved

All surgical procedures come with some risks. But, as brain surgery is a very complex and major medical event, it carries extra risk. The possible risks involved with brain surgery include:

  • Allergic reaction to anesthesia
  • Bleeding in the brain
  • A blood clot
  • Brain swelling
  • Coma
  • Impaired speech, vision, coordination, or balance
  • Infection in the brain or at the wound site
  • Memory problems
  • Seizures
  • Stroke

Following up after brain surgery

Immediately after the surgery, you will be under close observation to ensure everything works properly. You will be seated in a raised position to prevent any type of face or brain swelling. Recovery from brain surgery mainly depends on the type of procedure done. In ideal cases stay for brain surgery can last up to a week or more. How long you are going to stay in the hospital that depends on how well your body responds to the surgery. During  this time, you will be on pain medications. Before leaving the hospital, your doctor will explain the next steps of the process. If you are planning to go for your brain surgery in Australia then there are a number of modern brain surgery consultants in Sydney who can explain you the pre and post surgery procedure in vivid details.

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An Overview of Brain Surgery

When we say ‘brain surgery’, technically it refers to various medical procedures involved in repairing structural problems in the brain. Brain surgery is of multiple types and the type suggested to a particular person depends on the area of the brain being treated and the condition being treated. The latest advancements in this field have helped the surgeons to operate on certain parts of the brain without any incision in or near the head.

Brain surgery is considered one of the most complicated and critical processes of surgery. The type of brain surgery is being done mainly depends highly on the condition being treated. For example, a brain aneurysm can be treated using a catheter that’s introduced into an artery in the groin. Now, for instance, if the aneurysm has ruptured, the surgeon may have to opt for an open surgery called craniotomy. Thus, the surgeons try to be as thorough as possible to treat each surgery on a case-by-case basis.

One may have to go through a brain surgery if they have any of the following conditions in or around their brain:

  • Abnormal blood vessels
  • An aneurysm
  • Bleeding
  • Blood clots
  • Damage to the protective tissue called the “dura”
  • Epilepsy
  • Abscesses
  • Nerve damage or nerve irritation
  • Parkinson’s disease
  • Pressure after head injury
  • Skull fracture
  • A stroke
  • Brain tumors
  • Fluid building up in the brain

It’s not that all these health conditions would require brain surgery, but many of these symptoms may be helped by it. Especially, in cases where these symptoms pose serious threats to health. For example, a brain aneurysm doesn’t require open brain surgery, but you may have to opt for open surgery if the vessel ruptures. Some of the most efficient Australian brain surgeons have been doing these surgeries now for quite a long time saving life of many individuals suffering from such disorders.

What is Microsurgical Plastic Surgery

Microsurgery refers to any surgery performed under the expanded view through microscope. It utilizes magnification up to fifty times produced by the naked eyes and stitches finer than a hair and enables the surgeons to repair transected blood vessels and nerves that are less than 1mm in diameter. In case of plastic and reconstructive surgery, microsurgery has allowed far more perfection in many procedures. The advancement in the field of microsurgery has expanded the range of procedures, surgeons can perform safely with more precision.

Microsurgical procedure improves the ability of surgeons to help patients in complex surgical procedures such as reattaching amputated fingers. Microsurgery is invented to help surgeons to use special operating microscopes to transplant muscle, bone or large sections of tissue, from one part of the body to another. Taking help of the operating microscope, the area being operated is magnified and the blood vessels and the nerves from the part being moved are carefully reattached. Basically, it is done so that the transplanted tissue can live in the new location and the feelings in the transplanted tissue are maintained.

Surgeons take help of microsurgery to take tissue from the leg or back to reattach fingers, reconstruct a breast, or perform plastic or reconstructive surgery on nose, ears, hands, scalps, fingers, tongues, toes and other small yet significant body parts. Microsurgery is frequently used for complex cancer and trauma cases.

Cases demanding microsurgery can be very complex and challenging in the area of plastic and reconstructive surgery. Microsurgical surgery in Melbourne has seen better advancements and is being extensively used in the field of reconstructive surgery to perform hand and face transplantation. These techniques are opening up new avenues in life for severely injured patients whose problems can’t be solved by mere traditional techniques. Advanced computing and robotics are making the process of surgery, precise and more effective.

What is Awake Craniotomy?

As the name suggests, Awake Craniotomy is a neurosurgical technique used to remove a brain tumor while the patient remains awake to avoid brain damage. In this process of surgery the neurosurgeon performs cortical mapping to locate vital areas, referred to as ‘eloquent brain’ which should not be disturbed while removing the tumor. This process of craniotomy is a preferred technique to operate and remove lesions involving eloquent or functionally important parts of the brain. This procedure allows the surgeons to test regions of the brain before they are incised or removed. It also allows to test the functions of the patient throughout the process of operation. The overall motive behind such surgery is to minimize the risks involved with such operations.

How an Awake Craniotomy is Performed

In Awake Craniotomy the patient is taken to the anesthetic room where they will have a drip inserted with some drugs making them feel comfortable and relaxed. Then in the operation theatre, neuronavigation system is used to mark out the incision. A very small amount of hair is shaved across the line of the incision and then cleaned with antiseptic solutions. After this local anaesthetic is inserted around the incision. In the beginning, it stings for a few seconds and then go numb. The surgeons then place some drapes around the wound while you will be able to see the anesthetic team, you will be able to move your arms and legs without any obstacle during the operation. While the operation process continues, for a brief period of time you will hear some noises and the drilling sound.

After mapping out the eloquent regions of the brain to avoid and save, the doctors remove the tumors. In this process, doctors constantly keep testing the patient’s function and in case anything happens, they can stop it immediately. Awake Craniotomy in Australia is getting quite popular these days.

Posterior Lumbar Discectomy: An Overview

A surgery on the lower spine to remove a damaged or herniated disc is referred to as posterior lumbar discectomy. In this process, an incision is made posterior, through the back muscles, for reaching and removing the disc that presses the nerve. Physicians recommend discectomy in those situations where physical therapy or medication fails to relieve leg or back pain caused by spinal nerves pinching. The surgery done to solve this problem can be performed open or through minimally invasive techniques.

The literal meaning of the term discectomy is “cutting out the disc.” A discectomy can be done at any spot near the spine from the neck (cervical) to the low back (lumbar). The surgeon accesses the damaged disc from the back of the spine-through the muscles and bone. To reach the disc, the surgeon removes a portion of the lamina. The lamina forms the backside of the spinal canal and creates a roof-like appearance over the spinal cord. After this, the spinal nerve is retracted to one side. Next, depending on the need of the case, one or more than one disc is removed.

To perform a discectomy, multiple varieties of surgical tools and instruments are used. If it is an open technique, it involves a large skin incision and muscle retraction to give access to the surgeon for an open view. On the other hand, a minimally invasive surgery uses an incision of a small area of skin. To make this process easier, multiple progressively larger tubes are inserted through the muscles. In case of minimally invasive incision the chances of the disruption of the back muscles get limited. It may also require less time to recover.

Lumbar Discectomy is performed on people when their diagnostic tests show a herniated disc. It is also suggested to people who have significant pain, numbness, weakness in their leg or foot.

Robotic Spinal Surgery and its Benefits

One of the latest advancements in the field of spinal and neurosurgery, robotic spinal surgery is available to the patients who rely only on leading edge technology in the operating theatre. In the traditional method of spinal surgery, surgeons place screws in the spinal bones either using their feel and judgement or take help of many X-rays taken during the procedure. If these X-rays are taken in large numbers, they expose the patient to significant amounts of radiation, which may be harmful for the patients. In this technique, there is a high risk of placing the screws in the wrong place. As a result, your patient may face paralysis or a less effective operation.

To get rid of these problems, robotic spinal surgery was conceived. It reduces the risk of screw misplacement. When Mazor Renaissance Robot is used, the surgeon remains in control of the surgery and places the screws with their hands. However, here the robot provides a guidance system, on the basis of computerized pre-operative plan. This process increases the degree of precision, which results in an accuracy of 1mm.

The robotic guidance system involved with the robot spine surgery allows surgeons to perform even the most complex types of spine surgery safely, accurately and efficiently. It limits radiation exposure, postoperative pain and the time of recovery.

Benefits of robotic spinal surgery

Spinal surgery is definitely the most challenging and risky surgery that people require. Variations in the anatomy of the patients, possibility of human error, combined with the complex nature of the spinal cord and nerves on which the operation is performed means that even a very minor mistake can cause a lot of havoc.

Hence, neurosurgeons are in constant search of ways to minimize the risk of surgery. Taking help of Renaissance Spinal Robot these risks can be reduced.

An Overview of Artificial Disc Surgery

An artificial disc is a device which is implanted into the spine to mimic the functions of a normal disc. The entire range of disc design is primarily divided into two general types: total disc replacement and disc nucleus replacement. In case of total disc replacement, almost all the disc tissues are removed and a replacement device is implanted into the space between the vertebra. In case of a disc nucleus replacement, only the nucleus or the disc center is removed to replace it with an implant. In this type of disc replacement, the outer part of the disc (the annulus) is not removed.

Usually artificial discs are made with a combination of metal or plastic-like (biopolymer) materials or either of the two. The materials used to make the artificial discs have been used in the human body for several years. The process of Total disc replacement has been performed since the late 1980s.

Who needs an Artificial Disc?

The indications for disc replacement may vary from instance to instance. Some general indications include pain arising from the disc that could not be reduced with non-operative care, like medication, injections, physical therapy or chiropractic care.

In an ideal situation, an MRI is done to show the disc degeneration. Often discography is performed to verify which disc (s) is related to your pain. To check if the person in question is fit for disc replacement or not, the surgeon may require a few tests, including:

  • X-rays
  • Discography
  • Computed tomography (CT) scans
  • Magnetic resonance imaging (MRI) scans

There are some circumstances where you can’t opt for an artificial disc surgery. For example, allergy to the device materials, spondylolisthesis, osteoporosis, vertebral body fracture, spinal tumor, spinal infection, morbid obesity, pregnancy, chronic steroid use or autoimmune problems.

Cavernous Malformation: An Overview

Vascular malformations refer to the localized collections of blood vessels that are not cancerous (nonneoplastic), abnormal in structure or number and lead to altered blood flow. While originally it was believed that the most vascular malformations are present at birth (congential), the lesions of cavernous malformation may develop throughout the lifetime of the affected individual. Other types of vascular malformations are not congential, but are caused by radiation, trauma or other injury to the spinal cord. The classifications of vascular malformations are done by size, location and type of change.

The four most common vascular malformations are capillary telangiectasias, cavernous malformations, venous malformations, and arteriovenous malformations.

Cavernous malformations are abnormal clusters of blood vessels that are characterized by multiple clusters of blood vessels with small bubbles or caverns through which the blood flows very slowly. Cavernous malformation vessels have a tendency to leak because of their thin wall. Due to this Leakage (bleeding) from these vascular lesions, the clinical symptoms associated with the illness appear. Though cavernous malformations are primarily found in the brain, sometimes they can be found on the skin, in the spinal cord, and in some rare cases in the retina as well.

Usually, cerebral cavernous malformations (CCMs) or  cavernous malformations brain is found in the cortex or white matter of the brain. Unlike other lesions such as arteriovenous malformations, CCMs do not have brain tissue within the malformation. Also CCMs usually are not encapsulated. CCMs are changing in size, dynamic in structures, and number over time.  The size of CCMs ranges from a few millimeters to several centimeters.

CCMs are found in up to 0.5% of the general population, and they constitute for a large proportion (8-15%) of all brain and spinal vascular malformations. The prevalence of people with at least one CCM lesion is high, while at least 40% of affected individuals may not have ever experienced symptoms of CCM or become diagnosed with cavernous malformation.

Cavernoma: Symptoms and Treatments

Cavernomas, also known as cavernous angiomas or cavernous malformations are abnormal clusters of blood vessels with small bubbles or caverns filled with blood give them the look of a berry. These berry like substances range from microscopic to several inches in diameter. Unlike AVMs or  arteriovenous malformations, the flow of blood is very low in cavernomas. Since the cavernomas wall are very weak, chances of blood leaking out are high. Cavernomas can occur in the brain and in the spinal cord. While a cavernous may not cause to affect function, it can cause stroke symptoms, seizures, headache and hemorrhages.

The risk factors of Cavernoma

It is estimated that around one in every 200 people have a  cavernous angioma. Anyone may be a patient of cavernoma and majority of diagnosed people do not report a family history. However, people with more than one cavernoma are suspected to have an inherited factor.

Symptoms of Cavernoma

Usually Cavernomas are diagnosed with after a loss of function, a seizure or from a surprise finding when an MRI is done for some other reason. Cavernomas may have no symptoms, but more than 30 percent people with cavernoma angiomas eventually develop symptoms. In most of the cases, these symptoms occur when patients are 20 to 40 years old. The frequency, type and severity of the symptoms mostly depend on the locations of the angioma. Some of the typical symptoms include

  • Headache
  • Epileptic seizure
  • Neurological loss, such as limb weakness, vision or balance problems, or problems with memory and attention
  • Brain hemorrhage, which can be small, but sometimes massive, leading to stroke-like symptoms
  • Spinal cord injury

Treatment of Cavernoma

Physicians evaluate how to treat cavernomas depending on – How the cavernomas are bleeding, Where the cavernomas are located, If there are multiple cavernomas, The presence of other endovascular abnormalities.

Depending on the detailed assessment of the aforesaid factors, following treatments are offered:

  • Watching and waiting: A lot of cavernomas are observed for changes, recent hemorrhage, or worsening symptoms.
  • Medications: Medicines can not directly treat cavernomas, but they can effectively treat symptoms like seizures and headaches.

Surgery: Cavenoma surgery is the only curative approach to cavernomas and is suggested for cavernous angiomas with latest hemorrhage and those expanding in size causing seizures.

Brain Tumor: Risk Factors and Diagnosis

A collection or mass of abnormal cells in your brain is called brain tumor. Your skull, which encloses your brain is very rigid. Any unusual growth in such a restricted space can cause disturbances. Brain tumors can be cancerous (malignant) or non-cancerous (benign) and when any of these tumors grow, they cause in increasing pressure inside the skull. This can cause brain damage which can be life threatening.

Brain cancers are mainly categorized as primary or secondary. Primary brain tumors originate in your brain and many of them are benign. On the other hand, secondary brain tumor, which is also known as metastatic brain tumor occurs when cancer cells spread to the brain from some other organs in the body such as lung or breast.

Risk Factors for a Brain Tumor

Family History: Only around 5 to 10 percent of all cancers is reported to be hereditary or genetically inherited. In case several people in your family have been diagnosed with a brain tumor, you are advised to consult your doctor. They can recommend a genetic counselor for you.

Age: Risk of maximum brain tumors increases with the age.

Chemical Exposure: If you are exposed to certain cancer causing chemicals in the workplace, the risk of brain cancers increases. The National Institute for Occupational Safety and Health has released a list of potential cancer-causing chemicals found in workplaces.

Exposure to Radiation: People exposed to ionizing radiation are more prone to the risk of brain tumors. You can be exposed to ionizing radiation through high radiation cancer therapies.

No History of Chicken Pox: According to the American Brain Tumor Association people who have a history of childhood chicken pox are less likely to get brain tumors.

Diagnosis of Brain Tumor

A physical examination and a thorough analysis of your medical history are the first steps in diagnosis. The physical exam involves a very detailed examination. Doctors test to see if your cranial nerves are intact. Cranial nerves originate in your brain. CT Scan, MRI, Angiography, Brain Scan, Skull X-Rays and last but not the least, Biopsy are various techniques used to diagnose brain tumors.

Australia hosts some of the best brain tumor surgeons who are using the most advanced techniques to remove and cure the tumors. The latest developments in this field include various laser techniques that are less painful and get cured in less time.