Neurosurgeons use a variety of surgical procedures to correct particular structural or functional defects in the brain.
Surgery can be considered for the following conditions:
- The presence of benign or malignant tumors, infections, or swelling in the brain tissue (oedema).
- Cerebral aneurysms, subdural haematomas, and subarachnoid or intraventricular haemorrhages are examples of abnormal or disrupted blood flow in the brain.
- Infections or hydrocephalus may cause changes in the cerebrospinal fluid.
- Brain function changes, such as epilepsy or Parkinson’s disease.
Surgical procedures that are performed on the brain by Dr. Gurneet Sawhney who is one of the best neurosurgeon in India are-
- Removal of tumors and other irregular tissue.
- Clipping of aneurysms.
- Blood or blood clots are removed from a leaking blood vessel.
- Following a traumatic event, repairing skull fractures or tears in the dura.
- Shunts are used to reduce intracranial pressure in people with hydrocephalus.
- The temporal lobectomy procedure is used to treat epilepsy.
- Electrons are inserted during Deep Brain Stimulation surgery to help people with Parkinson’s disease control their motor symptoms.
Depending on the location, scale, and surrounding architecture of the brain region needing access, the neurosurgeon will make a decision about which surgical technique to use.
Following are the majorly used brain surgeries in India-
Craniotomy
A high-speed drill is used to separate a disk of bone (or “bone flap”) from the skull during a craniotomy. This allows the surgeon to gain access to the brain and perform surgery. The bone flap is then replaced, and plates, sutures, or wires are used to protect it. Burr holes are small craniotomies the size of a dime, while keyholes are larger craniotomies. The scale of the craniotomy is determined by the underlying disorder being treated as well as the brain area that needs to be accessed.
Endoscopic Endonasal Surgery
Endoscopic endonasal surgery is a type of brain surgery that is performed with the least amount of invasiveness possible. An endoscope is a small, flexible tube with a light source and a camera that is threaded through the nose and sinuses. This allows the surgeon to enter parts of the brain that are difficult to reach with conventional surgical methods, such as incisions at the base of the skull or the top of the spine. The endoscope illuminates areas of the brain so that tumors or lesions can be removed using specially designed instruments inserted through the nose.
Neuroendoscopy
Neuroendoscopy, like endoscopic endonasal surgery, is a minimally invasive procedure performed using endoscopes. Small holes (about the size of a dime) are drilled into the skull, nose, or mouth during neuroendoscopy. The surgeon would then mount an endoscope.
Biopsy
A biopsy is an invasive procedure in which a small amount of brain tissue is surgically removed and examined under a microscope. The sample is examined for structural or functional anomalies that may aid in the diagnosis or prognosis of a particular condition. A neurosurgeon will dig a small hole in the skull when under general anaesthesia, then insert a thin needle to extract a small piece of tissue.
Stereotactic Brain Surgery (SBS)
In addition to craniotomies, biopsies, and endoscopic procedures, specialized imaging techniques such as magnetic resonance imaging (MRI) and computerized tomography (CT) scans can be used. Scans are normally performed several days prior to surgery. They assist the surgeon in pinpointing the exact location of a brain abnormality.
The images acquired during surgery are combined with the previously obtained 3-dimensional brain scans. They assist the neurosurgeon in determining the safest path through the surrounding brain in order to remove as much abnormal tissue as possible while avoiding damage to normal tissue. This technique’s increased precision reduces the risk of injury or disruption to surrounding tissue.
Awake Brain Surgery
While you are awake but sedated, neurosurgeons may perform brain surgery. Intraoperative brain imaging is the term for this. When working on tumors that are close to sensitive areas of the brain, neurosurgeons often use this technique (such as brain areas that control vision, language, memory, or body movements). Small electrodes are used by the surgeon to activate specific regions of the brain.
This is known as cortical mapping, and it aids in determining the function of brain regions surrounding the surgical site. A limb can twitch as a result of stimulation of a motor zone, while sensory areas may trigger a tingling sensation. The neurosurgeon may use cortical imaging to operate on complex areas of the brain with little chance of functional failure.