Brain Tumour Resection
Brain tumour resection is the surgical removal of a benign or malignant brain tumour via a craniotomy. The primary objectives are to safely remove as much of the tumour mass as possible (maximal safe resection), relieve intracranial pressure, alleviate neurological symptoms, and obtain a precise tissue sample for definitive histopathological and molecular diagnosis, which guides any further cancer therapies.
When this procedure may be recommended
- Malignant primary brain tumours, such as glioblastomas, astrocytomas, or oligodendrogliomas.
- Benign primary brain tumours, such as meningiomas, acoustic neuromas, or epidermoid cysts.
- Metastatic brain tumours originating from other cancers (lung, breast, melanoma).
- Intracranial mass effect causing neurological deficit, headaches, or seizures.
Who may be a candidate
Surgical resection is recommended for most patients with accessible brain tumours. Candidacy is determined by the tumour location, surgical accessibility, tumour type, the patient’s baseline neurological status, and overall medical fitness for general anaesthesia.
Advanced medical implant technology (no text). Alternatives to surgery
- Stereotactic biopsy only (if surgical removal is too high-risk due to deep location).
- Stereotactic radiosurgery (Gamma Knife) for small, deep, or medically inoperable tumours.
- Chemotherapy and radiation therapy (for highly sensitive tumours, or as adjuvant therapy).
- Palliative care and steroid therapy (dexamethasone) to manage brain swelling.
What to expect
- Plan & Navigation: The patient undergoes a high-resolution MRI scan. This 3D data is loaded into the surgical navigation system, which maps the exact location of the tumour.
- Access: A craniotomy is performed over the tumour site under general anaesthesia.
- Identification: The operating microscope and intraoperative ultrasound are used to distinguish the tumour tissue from healthy brain tissue.
- Resection: Specialized micro-surgical tools and ultrasonic aspirators are used to carefully dissect and remove the tumour from the surrounding brain.
- Verification: Neuromonitoring continuously tests nerve pathway integrity to ensure critical functions are protected.
- Reconstruction: The dura is sutured, the bone flap is secured with titanium plates, and the scalp is closed.
Technology and imaging
Employs 5-ALA fluorescence-guided surgery (making malignant gliomas glow pink under blue light), intraoperative ultrasound, navigation guidance, and ultrasonic tissue aspirators.
High-precision diagnostic imaging visualization. 
Clinical Zeiss/Leica operating microscope setup. Hospital stay
Typically 3 to 5 nights in hospital, beginning with 1 night of ICU/HDU monitoring.
Recovery milestones
- Day 1: Monitored in the ICU. Neurological examinations are performed hourly.
- Days 2-4: Mobilisation on the ward, removal of wound drains, and assessment of speech and physical therapy needs.
- Weeks 1-6: Home recovery. Avoid strenuous exercise and heavy lifting. Scalp stitches or staples are removed at 10-14 days.
- Oncology Hand-off: Pathological results are discussed within 7-10 days to coordinate any necessary radiation or chemotherapy.
Post-operative mobilization and recovery milestones. Risks and complications
- Persistent or new neurological deficits (weakness, numbness, speech or vision changes).
- Brain swelling (edema) or bleeding (hematoma) requiring re-operation (1% to 2% risk).
- Seizures (often managed with temporary anti-seizure medications).
- Cerebrospinal fluid leak or meningitis.
Frequently asked questions
What is the benefit of fluorescence-guided (5-ALA) surgery?
5-ALA is a drink taken before surgery that causes high-grade glioma cells to glow bright fluorescent pink under a special blue light on the operating microscope. This allows the surgeon to identify and remove tumour margins that would otherwise be invisible, leading to a much safer and more complete resection.
Will surgery cure my brain tumour?
For benign tumours like meningiomas, surgical resection can be curative. For malignant tumours, surgery is the crucial first step to decompress the brain and obtain a diagnosis, and is followed by radiation and chemotherapy to treat any remaining microscopic cells.