Brain Procedures

Bifrontal Craniotomy for Tumor

This surgery is used to remove a tumor from the frontal lobe of the brain. The procedure is performed under general anesthesia and requires a hospital stay.

Bifrontal Craniotomy for Tumor

Burr Hole Drainage

This treatment is performed on a chronic subdural hematoma, a  collection of blood or a blood clot that exists between the layers of tissue in the brain, which is often the result of head injury. In the case of chronic subdural hematomas (rather than acute), the bleeding may be slow and pressure may build over time. The symptoms probably won’t be apparent immediately after the injury, but in some cases, the bleeding and increased pressure on the brain can be life- threatening, so medical attention is required. In this procedure, a small portion of the scalp will be shaved for the placement of the burr hole. The surgeon will use a special medical drill that is designed to stop once the skull is penetrated eliminating the risk of damage to the brain. Once the hole is drilled, a scalpel will be used to cut the dura (covering of the brain) so that the blood or blood clot can be drained or removed. In the case of a craniotomy, more than one burr hole is drilled and a portion of the skull is removed which gives the surgeon more room to work with and better visibility. Craniotomies are used most often with larger blood clots and acute subdural hematomas which are generally the result of traumatic head injury and require emergency treatment. Once the clot has been removed or the blood has been drained the dura and the scalp will be sewn shut. In some cases, a drain made be left in place to continue removal of blood or fluid over the course of several days.

Burr Hole Drainage

Craniectomy for Chiari Malformation (Foramen Magnum Decompression)

The goal in this surgical treatment is to provide more room for the brain and the brain tonsils. To begin with, the surgeon will perform a craniectomy, or removal of some of the bone located at the base of the skull right above the spinal cord. Additionally, the dura, or brain covering, will most likely need more room as well, so it is also opened and a patch is sewn in for its expansion. The surgeon may also decide to perform a laminectomy (see spine procedures) on the top level(s) of the spine (C1 – C3)  if there is evidence that it is needed or would be beneficial.

Craniectomy for Chiari Malformation

Cranioplasty

The goal of this procedure is to repair or reshape irregularities  or imperfections in the skull. The surgeon may choose to either use a bone graft from elsewhere in the patient’s body or a synthetic material to correct the defects or gaps in the skull bones which may be the result of head trauma or a recent medical condition. To begin with, the incision area is cleaned and shaved if needed and incisions are made to expose the area being treated. In some cases, a portion of the skull may be removed, reshaped and reattached later. In other scenarios, a portion of bone from another part of the body may be taken, shaped and used or a synthetic material may also be utilized. The specific course of action will be determined by the surgeon’s experience and the patient’s particular needs. Additionally, the surrounding bone edges are cleaned and treated to improve grafting attachment. The bone graft or substitute material is put in place using special discs, plates and screws.

Cranioplasty

Microvascular Decompression for Trigeminal Neuralgia

This procedure eliminates (or greatly reduces) the sharp bursts of pain in the facial nerves caused by trigeminal neuralgia. The procedure is performed under general anesthesia and requires a short hospital stay.

Microvascular Decompression for Trigeminal Neuralgia

Normal Pressure Hydrocephalus (NPH):

The treatment of choice for NPH patients who show a positive response to diagnostic testing is the placement of a CSF (Cerebral and Spinal Fluid) shunt which is an implantable device that is designed to drain excess CSF away from the brain and into the stomach where it can easily be absorbed. There are 2 options for shunt devices, and the surgeon will choose the one that best fits each case.  Incisions may be made in more than one location of the body based upon the surgeon’s experience, technique, and choice of shunt. The shunt is meant to stay permanently in place; the procedure will not cure NPH, but it should help alleviate some of the problems and symptoms.

Resection of Cerebral Arteriovenous Malformation

In this procedure, performed under general anesthesia, the surgeon opens the skull to remove an abnormal tangle of enlarged blood vessels called a cerebral arteriovenous malformation (or AVM). This procedure is generally used for small AVMs that are located on or near the surface of the brain.

Resection of Cerebral Arteriovenous Malformation

Stereotactic Biopsy

In this surgical procedure, the physician takes a small sample of tissue from the brain through a hole in the skull. Stereotactic biopsy is commonly used to take a sample from a tumor. The procedure is usually performed under local anesthesia and requires at least an overnight hospital stay.

Stereotactic Biopsy

Suboccipital Craniectomy for Acoustic Neuroma

This surgery is used to remove an acoustic neuroma, a type of noncancerous tumor that forms on a nerve in the middle ear. The procedure is performed under general anesthesia and requires a hospital stay.

Suboccipital Craniectomy for Acoustic Neuroma

Transsphenoidal Surgery for Tumor

This endoscopic procedure, performed under general anesthesia, is used to remove a tumor from the pituitary gland. The patient will require hospitalization for two to five days after the surgery.

Transsphenoidal Surgery for Tumor

Ventriculoperitoneal Shunt for Hydrocephalus

During this surgical procedure, a small drainage tube is implanted to relieve the pressure of hydrocephalus. Hydrocephalus is a condition that develops when excess cerebrospinal fluid builds up within the ventricles of the brain.

Ventriculoperitoneal Shunt for Hydrocephalus