Neurosurgery

Neurosurgery [NOO-roh-SUR-jur-ee] is a surgery that a doctor does on your child’s brain or the tissue around their brain.

Brain surgery is done by a special kind of surgeon called a neurosurgeon. A neurosurgeon often works with a neurologist, a doctor who specializes in studying and diagnosing problems, injuries, diseases, and conditions that affect the brain.

Different kinds of neurosurgery can be used to treat different conditions, diseases, and injuries. Some surgeries are used to:

• Stop blood flow to an aneurysm [ANN-yer-IZ-uhm] that is causing symptoms or that is dangerous.
• Remove abnormal or diseased brain tissue.
• Drain blood or an infection.
• Free a vein that is caught or snagged.

What Kinds of Neurosurgery Are There?

The specific way that neurosurgery is done will depend on the reason for the surgery.  Some specific kinds of brain surgery include:

• Gamma knife surgery. This procedure is not an invasive surgery. Instead, gamma rays (high-energy waves like x-rays) are aimed at a tumor in your child’s brain to help remove it or reduce its size.
• Spinal stenosis [steh-NO-sis] surgery. The spine can narrow, putting more pressure on your child’s nerves and causing pain and other problems. This is more common in older people, but children can have spinal stenosis, too. Spinal stenosis surgery to heal this condition is sometimes done near your child’s neck and brain.

There are many other specific types of surgery that may be done depending on the specific condition your child has.

All surgery has risks, and you should talk to your child’s doctor about deciding if the benefits of surgery outweigh the chance that something could go wrong. Common surgery risks include:

• Bad reactions to medicines used during surgery, especially to anesthesia [ann-ess-TEE-see-uh], the medicine that surgeons use to put your child to sleep for their surgery.
• Problems breathing during surgery, either because of the surgery itself or the anesthesia used to put your child to sleep.
• Bleeding, blood clots, and infection at or near the site of the surgery.

Risks of Neurosurgery

Your child’s brain controls every other part of their body. This means that brain surgery can have many other risks due to hurting the brain or other causes. Some of the most common risks of brain surgery are:

• Seizures
• Stroke
• Coma
• Infections in the brain or skull
• Brain swelling

Depending on where the surgeon is operating, brain surgery can also cause problems with your child’s speech, memory, balance, vision, and other functions like their ability to stay coordinated and use their muscles. Usually, these problems go away, but they might be permanent.

Neurosurgery can be used to cure or help many conditions, injuries, diseases, and other problems with the brain. Some of the most common reasons for a brain surgery are:

• Brain tumor
• Bleeding in the brain (hemorrhage [HEH-mor-ij])
• Blood clots in the brain (hematoma [HEE-muh-TOE-muh])
• Weakness in blood vessels
• Brain infections
• Epilepsy [EH-pih-LEHP-see]
• Installing a device in the brain that helps with another condition or disease, like Parkinson’s disease
• Swelling in the brain
• Skull fractures that can only be fixed with surgery

Before the Surgery

Your child’s doctor will do a physical exam, and might use imaging tests like a CT scan, MRI, or x-ray to look at their brain before the surgery. During this exam, you should tell the doctor:

• If your child is taking any medicines, including over-the-counter medicines as well as any vitamins, herbs, or supplements
• If your child has any allergies or reactions to certain medicines
• If you think your older child might be pregnant

A Few Days Before Neurosurgery

In the days leading up to your surgery, your child's doctor might ask you to:

• Stop taking certain medicines like aspirin, ibuprofen, warfarin, and blood thinners.
• Wash your child’s hair with special shampoo the day before the surgery. This can help doctors work on their skull more easily.

On the Day of the Surgery

To help prepare for your surgery, your doctor might ask your child to not eat or drink for 12 hours before the surgery. This can help prevent nausea from the medicines that are used for surgery.

The specific way that neurosurgery is done will depend on the reason for the surgery, but there are some steps that happen in most neurosurgeries:

• Your child’s surgeon will shave the scalp in the area where they will make the cut.
• The surgeon will cut a hole in your child’s skull and remove a flap of bone. Sometimes, the surgeon can make a smaller hole and use a tube with a camera on the end to work on your child’s brain. The smaller hole means that your child can recover from the surgery faster and with less pain.
• An MRI or CT scan can help the doctor find the right place to put the camera.
• Your child’s surgeon will operate on their brain. Depending on the reason for the surgery, they might remove the tumor, take out brain tissue that is diseased, or free a trapped nerve.

You might know the results of your child’s neurosurgery right away, but depending on the condition that needed surgery, it might take weeks or months to see improvement in your child’s symptoms. You should talk to your child’s neurologist and neurosurgeon about how long it will take to for your child to recover and improve.

Depending on the kind of neurosurgery your child had, they might not need any follow-up, but it is likely that your doctor and surgeon will want them to come in for more tests and evaluations after the procedure.

These tests can help make sure that your child is recovering after the surgery, and can show if the surgery worked.

You should talk to your child’s doctor and surgeon about how long it will take them to recover fully and what follow-up tests they might need.

Neurosurgery [NOO-roh-SUR-jur-ee] is a surgery done on the brain. It is done by a specialized surgeon called a neurosurgeon. There are many kinds of neurosurgery that can be used to fix conditions that may affect your child’s brain, including cancer, aneurysms, infections, and other problems.