Stereotactic Brain Surgery
What is it?
A stereotactic brain surgery is a surgical procedure where lesion, frequently a brain tumor, is removed with assistance of image guidance, that is previously obtained images (usually an MRI) are used to guide the surgeon to the exact location of the lesion to facilitate as accurate a pathway through the brain and safe removal of as much abnormal tissue as possible while leaving normal, healthy brain relatively intact.
What is its goal?
The goal of this kind of surgery is typically to remove an abnormality seen on an MRI or CT scan. Because MRI and CT scans are very good at showing parts of the brain that are abnormal, they can assist us in surgery on the brain to identify the safest way to traverse surrounding brain and remove as much abnormal tissue as possible while minimizing the disruption of surrounding normal healthy tissue.
How is it done?
Stereotactic brain surgery is performed with a computer system that integrates previous imaging, usually a special MRI or CT performed one or two days before the surgery. This image is imported into the computer system that provides us with a 3-dimensional image of your brain and our intended target while we are in the operating room. We use this image, along with instruments that show us exactly where we are in the brain as we work to guide our removal of the target lesion.
Stereotactic brain surgery gives us the added advantage of planning as an small incision as possible over the target area of interest. This generally results in smaller incision, which results in better wound healing and smaller scars.
What are the risks?
The biggest risk is bleeding in the tumor and brain from the surgery. Bleeding can cause anything from a mild headache up to a stroke, coma, or even death. The risk of bleeding following surgery is around 5% and the risk of mortality is around 1%. Additional risks can include headache from the surgical site, infection, and seizures. Additional risks can be posed by the anesthesia itself. To minimize risk, we ensure that a patient’s medical condition is optimized before beginning surgery, use of intraoperative antibiotics, stop all blood thinners including aspirin before surgery, and keep everyone overnight in the hospital for observation at the completion of surgery.
How long will I stay in the hospital?
The surgery itself generally requires a 2-3 day stay, but because some patients will have other problems such as seizures, weakness, or coordination problems associated with their disease, additional hospital time may be needed to address or treat those problems separate from the surgery.