Shooting Stock: It’s Not Brain Surgery

Gamma Knife® surgery is a treatment method that uses radiation and computer-guided planning to treat brain tumors, vascular malformations and other abnormalities in the brain. Despite its name, this procedure does not involve any incisions, not even a skin incision. The Gamma knife is actually a treatment that delivers beams of highly focused radiation. Some 192 "beamlets" of radiation converge and are precisely focused on the targeted area of brain, specifically in the shape of the tumor or lesion, while sparing the surrounding normal tissue.

If your doctor sees that an aneurysm has burst, they may do surgery to clip the aneurysm and prevent additional bleeding. Likewise, a craniotomy may be needed to relieve the pressure on the brain after a large stroke.

There are several potential complications of endovascular treatment. The most serious risk from carotid stenting is an embolism caused by a disrupted plaque particle breaking free from the site. This can block an artery in the brain, causing a stroke. These risks are minimized using small filters called embolic protection devices in conjunction with angioplasty and stenting. There is also a slight risk of stroke due to a loose piece of plaque or a blood clot blocking an artery during or right after surgery. The risks are balanced against the advantages of a shorter occlusion time (10 seconds, as opposed to 30 minutes for endarterectomy), shorter anesthesia and a small leg incision.

Hemorrhagic stroke usually requires surgery to relieve intracranial (within the skull) pressure caused by bleeding. Surgical treatment for hemorrhagic stroke caused by an aneurysm or defective blood vessel can prevent additional strokes. Surgery may be performed to seal off the defective blood vessel and redirect blood flow to other vessels that supply blood to the same region of the brain.

For a patient with a ruptured cerebral aneurysm, surgical elimination of the aneurysm is only the beginning. Intensive care recovery for the next 10-14 days is the rule, during which time a multitude of complications related to subarachnoid hemorrhage (SAH) can and do occur. At some time during that period (often immediately upon completion of surgery), cerebral angiography or a substitute study is done to document that the aneurysm has been eliminated. The first two to five days after SAH represent the greatest threat of brain swelling; at which time special measures (both medical and surgical) are used to diminish the effect of swelling on intracranial pressure. Near the end of this initial period, the risk period for delayed cerebral vasospasm begins and lasts the better part of the next 14 days. Intercurrent infections such as pneumonia are common, and hydrocephalus may develop.

Brain scans will show what type of stroke you had. You may also work with a neurologist who treats brain disorders, a neurosurgeon who performs surgery on the brain, or a specialist in another area of medicine.

There's always the risk of complications during surgery, and patients may be at risk of stroke during the removal of a brain tumor. In addition, temporary swelling of the brain may occur following surgery or focused radiation therapy.

Carotid endarterectomy. Carotid endarterectomy is surgery to remove plaque and clots from the carotid arteries, located in the neck. These arteries supply the brain with blood from the heart. Endarterectomy may help stop a stroke from occurring

Brain tumors are treated with surgery, radiation therapy and chemotherapy. Our doctors also are studying a vaccine for treating a recurrent cancer of the central nervous system that occurs primarily in the brain, known as glioma.

Other advanced techniques during surgery include brain mapping to find functional pathways near tumors, endoscopy to perform biopsies and open spinal fluid pathways through a small scope and advanced frameless stereotaxic computer assisted tumor resections. Intraoperative MRI also is available to help maximize tumor removal.

The Gamma Knife, or stereotactic radiosurgery, is another way to treat brain tumors. The Gamma Knife isn't actually a knife, but a radiation therapy technique that delivers a single, finely focused, high dose of radiation precisely to its target. Treatment is given in just one session. High-energy rays are aimed at the tumor from many angles. In this way, a high dose of radiation reaches the tumor without damaging other brain tissue.

The goal of cerebral bypass surgery is to restore blood flow to the brain and reduce the risk of stroke. The effectiveness of bypass depends on the type of graft used and the underlying condition being treated.

Although bypass surgery improves blood supply to the brain, it doesn't cure underlying carotid artery or cerebrovascular disease. Your results and long-term outcome will depend in part on taking medications as directed and following a healthy lifestyle: stop smoking, eat right, reduce cholesterol, maintain a healthy weight, control blood pressure, manage diabetes, and exercise.

Treatment may include some combination of surgery, radiation therapy and chemotherapy.[1] If seizures occur, anticonvulsant medication may be needed.[1] Dexamethasone and furosemide are medications that may be used to decrease swelling around the tumor.[1] Some tumors grow gradually, requiring only monitoring and possibly needing no further intervention.[1] Treatments that use a person's immune system are being studied.[2] Outcomes for malignant tumors vary considerably depending on the type of tumor and how far it has spread at diagnosis.[3] Although benign tumors only grow in one area, they may still be life-threatening depending on their size and location.[8] Malignant glioblastomas usually have very poor outcomes, while benign meningiomas usually have good outcomes.[3] The average five-year survival rate for all (malignant) brain cancers in the United States is 33%.[4]

Magnetic Resonance Angiography (MRA)- looks at the blood vessels in the brain. In the diagnosis of brain tumor, MRAs are typically carried out before surgery to help surgeons get a better understanding of the tumor vasculature. For example, a study was done where surgeons were able to separate benign brain tumors from malignant ones by analyzing the shapes of the blood vessels that were extracted from MRA.[41] Although not required, some MRA may inject contrast agent, gadolinium, into the patient to get an enhanced image

However, these techniques cannot alone diagnose high- versus low-grade gliomas, and thus the definitive diagnosis of brain tumor should only be confirmed by histological examination of tumor tissue samples obtained either by means of brain biopsy or open surgery. The histological examination is essential for determining the appropriate treatment and the correct prognosis. This examination, performed by a pathologist, typically has three stages: interoperative examination of fresh tissue, preliminary microscopic examination of prepared tissues, and follow-up examination of prepared tissues after immunohistochemical staining or genetic analysis.[citation needed]

Radiosurgery is a treatment method that uses computerized calculations to focus radiation at the site of the tumor while minimizing the radiation dose to the surrounding brain. Radiosurgery may be an adjunct to other treatments, or it may represent the primary treatment technique for some tumors. Forms used include stereotactic radiosurgery, such as Gamma knife, Cyberknife or Novalis Tx radiosurgery.[69][unreliable medical source?]

People who receive stereotactic radiosurgery (SRS) and whole-brain radiation therapy (WBRT) for the treatment of metastatic brain tumors have more than twice the risk of developing learning and memory problems than those treated with SRS alone.[71][72] Results of a 2021 systematic review found that when using SRS as the initial treatment, survival or death related to brain metastasis was not greater than alone versus SRS with WBRT.[73]

Patients undergoing chemotherapy are administered drugs designed to kill tumor cells.[56] Although chemotherapy may improve overall survival in patients with the most malignant primary brain tumors, it does so in only about 20 percent of patients. Chemotherapy is often used in young children instead of radiation, as radiation may have negative effects on the developing brain. The decision to prescribe this treatment is based on a patient's overall health, type of tumor, and extent of cancer. The toxicity and many side effects of the drugs, and the uncertain outcome of chemotherapy in brain tumors puts this treatment further down the line of treatment options with surgery and radiation therapy preferred.[75]

The prognosis of brain cancer depends on the type of cancer diagnosed. Medulloblastoma has a good prognosis with chemotherapy, radiotherapy, and surgical resection while glioblastoma multiforme has a median survival of only 12 months even with aggressive chemoradiotherapy and surgery. Brainstem gliomas have the poorest prognosis of any form of brain cancer, with most patients dying within one year, even with therapy that typically consists of radiation to the tumor along with corticosteroids. However, one type, focal brainstem gliomas in children, seems open to exceptional prognosis and long-term survival has frequently been reported.[78]

A common punchline is for the user to realize or be reminded immediately after saying the phrase that what he's describing actually is Rocket Surgery. A variant is to claim that an instance of rocket science "isn't brain surgery", or vice versa, with obligatory Lampshade Hanging.

Hi Frank, I had the same experience and thought I was having a brain hemorrhage. My jaw, my ear, my eye and the right side of my head/ brain felt like I was having an aneurysm. However the pain did get better and is almost nil now. My surgery was on June 29th. So about 5 weeks ago. Right after the surgery I could not eat or drink anything without hurting so bad. But now all is fine. I did mention it to my surgeon and to The Sleep therapist and they said a small percentage of people to experience this. 2b1af7f3a8