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What are Tumors?

Patients suffering from conditions within the skull, like brain tumors, need a craniotomy.

A tumor is an abnormal growth that occurs due to uncontrolled cell multiplication. In the skull, tumors can cause pressure on the brain because of the fixed size of the skull.

Tumors can be classified by their origin. Primary tumors are those located at the site where the tumor began to grow or where it originated. Metastatic, or secondary, tumors are those that have spread to other parts of body from the original tumor site.

Tumors are also classified based on their tendency to grow. Malignant, or cancerous, tumors tend to keep growing despite treatment and can become life threatening. Benign, or non-cancerous, tumors tend to grow more slowly and can be cured by treatment. However, benign tumors can still cause problems because of the pressure they cause on the surrounding brain tissue. In some cases, benign tumors can be life threatening.

Brain Tumor Treatment

If the tumor is static or growing slowly and does not cause pressure on the adjacent brain tissue, we may utilize conservative therapy. Patients are closely monitored regularly with MRI scans, and if the tumor grows or the patient develops symptoms related to it, we start treatment.

If the tumor is growing fast, or is life threatening, we may utilize definitive therapy. This includes more aggressive treatment techniques such as surgery, radiation therapy, or chemotherapy. Biopsies and surgical treatment of brain tumors typically require a craniotomy.

What is a Craniotomy and Who Needs One?

A craniotomy is a surgical procedure that involves removal of a portion of the skull, or cranium, to access the brain.

This surgery is performed by a neurosurgeon while the patient is under anesthesia. A craniotomy can be performed on any part of the skull depending on the location of the brain that needs to be accessed. The portion of the skull that is cut out is called a bone flap.

Symptoms of Brain Tumors

There are many types of brain tumors and a patient’s symptoms will depend on the specific type, size, and location of the tumor.

To diagnose a tumor, your doctor will perform a neurological exam to assess the function of your eyes, ears, nose, muscles, sensations, balance, coordination, mental state, and memory. To confirm the diagnosis, imaging studies such as magnetic resonance imaging, or MRI, and computed tomography, or CT, scans may be used. They may also order a biopsy to examine a sample of tissue from the tumor.

  • Headaches are one of the most common symptoms of brain tumors. Specifically, headaches upon waking, non-migraine headaches accompanied by vomiting, headaches accompanied by double vision, numbness, or weakness, and headaches accompanied by neck pain.
  • Seizure
  • Changes in personality or behavior, including odd mental or emotional events
  • Changes in mental function, such as memory loss, confusion, speech difficulty, impaired concentration or reasoning
  • Increase in sleeping time
  • Gradual loss of movement or sensation in arms or legs, balance problems
  • Difficulties with speech and comprehension
  • Visual problems

Before the Procedure

The patient lies on an operating table and is given general anesthesia. We then place their head in a device to keep their head in a fixed position during the procedure.

Initial Incision

Some hair may be shaved to clear the incision area. The surgeon makes an incision in the skin. Next, the skin and surrounding muscles are moved aside.

Exposing the Dura

The bone in the exposed part of the skull is cut and the bone flap is lifted. This exposes the covering, called the dura, that protects the brain tissues.

Locating the Tumor

The dura is cut, and we locate the tumor.

Removing the Tumor

The tumor is separated from the surrounding tissue and removed. If there are critical brain tissue or nerves near the tumor, monitoring techniques are used to make the surgery safer.

Ending the Procedure

The dura is closed and the bone flap is replaced. Finally, the skin is restored to its original position and sutured.

What happens after the Craniotomy for a Brain Tumor is Performed?

After surgery, we move the patient to an intensive care unit, or ICU, for close monitoring of their vital signs. They may stay on ventilation and breathing tube for some time.
After the procedure, the patients may have a headache or feel nauseated. The patient will remain in the hospital for a few days and receive some short-term rehabilitation.

This material is intended to give the patient an overview of surgical procedures and treatments and is not intended to replace the advice and guidance of a physician. Always consult with your doctor about the particular risks and benefits of your treatment.

Our Physicians

Jonathan D. Chilton, MD FAANS
Geoffery L. Blatt, MD FAANS
Peter Basta, MD FAANS
Jayson A. Neil, MD FAANS
Samuel Taylon, MD
Frances Hardaway, MD
Matthew J. Pierson, MD