Surgery is done to remove a tumor. This can lead to a cure for some types of tumors, but not others.
Taking out some of the tumor may help ease pressure on other structures. It may also improve outcomes of other treatments a person may need.
Tissue from the surgery will be looked at in a lab to find out the type of tumor a person has. More studies may also be done to classify the tumor, guide treatment, and find out more about a person's health outlook.
Options for Surgery
Mapping is done to find out what function is connected to what part of the brain. It tests places in and around the tumor. This helps find what can be removed or what problems may happen after surgery. This is done by:
- Stimulating brain tissue with electrical currents
- Measuring brain waves as they are stimulated
- Using ultrasound probes inside or near brain structures
- Probing the brain with computerized devices
- Functional MRI scan
- PET or SPECT scans
- Magnetoencephalogram (MEG) to find the source of motor, sensory, and language function
Open craniotomy is the removal of a piece of the skull. Some tumors are best removed through the nose or the top of the neck. But, most go through the skull. The area of skull that is removed will depend on where the tumor is. In some people, the brain may need to be mapped. Brain surgery may take many hours.
In some people, the tumor may be treated with:
- Thermal destruction—Heat from lasers or other tools can be sent to the exact location of the tumor
- Ultrasonic aspiration—Breaks up tumor tissue and removes it from the brain, which may result in less harm to healthy brain tissue
- Internal radiation therapy or chemotherapy placed in or near the tumor
A biopsy may also be done.
Angiography can be done to find a tumor's blood supply. It can then be shut off by placing plugs in the blood vessels. The tumor tissue may die from lack of blood. This procedure is not done often as it is not helpful to most people.
Some surgery may be done to ease problems or to deliver treatments.
Tumors can block the flow of cerebrospinal fluid (CSF) in the skull. This makes pressure in the brain higher. A cerebral shunt may be done if pressure is causing problems. The shunt helps manage the pressure of CFS.
A shunt is created by making a small hole in the skull. A tube is placed into one of the fluid filled spaces inside the brain. The other end of the tube is passed under the skin from the head to the trunk. It will drain fluid into the heart or belly. A one-way valve in the tube stops fluid from flowing backwards.
Ventricular Access Catheter
There is a barrier around the brain that blocks certain medicines from going into the brain. A ventricular access catheter (VAC) allows the medicines to be passed into the brain and surrounding fluid to treat the tumor.
A small hole is made in the skull. A tube is inserted into the fluid-filled space inside the brain. The other end of the tube has a reservoir that stays under the scalp. Medicines are given by a putting a small needle into the reservoir.
Adult central nervous system tumors treatment (PDQ®)–health professional version. National Cancer Institute website. Available at: https://www.cancer.gov/types/brain/hp/adult-brain-treatment-pdq. Accessed July 13, 2021.
Astrocytoma and oligodentroglioma in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/astrocytoma-and-oligodendroglioma-in-adults. Accessed July 13, 2021.
Craniotomy. Johns Hopkins Medicine website. Available at: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/craniotomy. Accessed July 13, 2021.
Horbinski C, Ligon KL, et al. The medical necessity of advanced molecular testing in the diagnosis and treatment of brain tumor patients. Neuro Oncol. 2019;21(12):1498-1508.
Kam KL, Appin CL, et al. Is next-generation sequencing alone sufficient to reliably diagnose gliomas? J Neuropathol Exp Neurol. 2020;79(7):763-766.
Meningioma. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/meningioma. Accessed July 13, 2021.
Overview of intracranial tumors. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/neurologic-disorders/intracranial-and-spinal-tumors/overview-of-intracranial-tumors. Accessed July 13, 2021.
Surgery for adult brain and spinal cord tumors. American Cancer Society website. Available at: https://www.cancer.org/cancer/brain-spinal-cord-tumors-adults/treating/surgery.html. Accessed July 13, 2021.
Youngblood MW, Stupp R, et al. Role of resection in glioblastoma management. Neurosurg Clin N Am. 2021;32(1):9-22.
Last reviewed July 2021 by EBSCO Medical Review Board Rimas Lukas, MD Last Updated: 7/13/2021