Surgical removal of benign or malignant tumors in brain tissue under a microscope, with awake craniotomy and neuronavigation when necessary.
Indication
- Benign brain tumors (meningioma, schwannoma, pituitary adenoma)
- Malignant primary brain tumors (glioma, glioblastoma)
- Metastatic brain tumors (originating from lung, breast, kidney, melanoma)
- Mass lesions causing visual field loss, headache, seizures or neurological deficit
- Tumors blocking cerebrospinal fluid (CSF) circulation
- Deep-seated lesions requiring diagnostic biopsy
Preparation
- Contrast-enhanced brain MRI and, when needed, functional MRI (fMRI) and DTI tractography
- Blood tests, ECG and anesthesia consultation
- Adjustment of anticoagulant and antiplatelet medications with physician approval
- No food or drink for 8 hours before the procedure
- Specific cleansing and shaving when needed in the surgical area on the scalp
How it's performed
- The patient is taken to the operating room; blood pressure, heart rhythm and oxygen levels are continuously monitored
- General anesthesia is administered; awake craniotomy may be preferred for tumors near speech or motor centers
- The surgical area is planned three-dimensionally with a neuronavigation system
- The scalp is opened and a window is created in the skull (craniotomy)
- Tumor borders are defined and the tumor is removed using a surgical microscope and, when needed, fluorescent staining (5-ALA)
- The skull bone is replaced and tissues are closed in layers
Post-procedure
- Monitoring in intensive care for 24-48 hours; neurological examination is repeated regularly
- Follow-up CT or MRI is performed in the early period
- Total hospital stay averages 5-10 days, varying by tumor type and clinical course
- Radiotherapy and/or chemotherapy may be planned according to the pathology result
- MRI follow-up at three-month intervals and review by the neurosurgery-oncology council
Risks
- Speech, movement or visual disturbance (temporary or permanent neurological deficit related to tumor location)
- Postoperative bleeding (intracranial hematoma) and brain edema
- Infection (wound infection, meningitis) and cerebrospinal fluid leak
- Development of seizures (epilepsy) or change in control of existing seizures
- Anesthesia reactions, deep vein thrombosis and pulmonary embolism
FAQ
When is awake craniotomy preferred?
If the tumor is close to critical brain regions related to speech, movement or memory, the patient is kept awake at certain stages of surgery to preserve these functions. There is no pain sensation; brain tissue itself has no pain receptors.
Can the entire tumor always be removed?
The type of tumor, its location and its relation to critical structures are decisive. In some cases, subtotal (partial) resection is performed to preserve neurological function and treatment is completed with radiotherapy/chemotherapy. A definite success rate or complete recovery cannot be guaranteed.
When can I return to work after surgery?
It depends on the tumor type, the size of the surgery and neurological status; a gradual return is generally planned within 4-12 weeks. The pathology result may require additional treatment.
Will my hair fall out?
Only a narrow area near the surgical site is shaved; cutting all the hair is not necessary. Hair regrows within 2-3 months.
Related Information
Related Medical Services
Other services in the same specialty or with similar indications you may want to explore.
VP shunt surgery
Neurosurgery
Ventriculoperitoneal (VP) shunt surgery — diversion of cerebrospinal fluid into the abdominal cavity in hydrocephalus.
Spinal tumor surgery
Neurosurgery
Spinal tumor surgery — neurosurgical removal of tumors of the spine and spinal cord.
Subdural hematoma drainage
Neurosurgery
Subdural hematoma drainage — surgical evacuation of blood collected between the brain surface and the dura.
Craniotomy
Neurosurgery
Craniotomy — brain surgery performed by temporarily opening a window in the skull.
Lumbar Disc Herniation Surgery
Neurosurgery
Lumbar disc herniation surgery — neurosurgery for lumbar disc herniation that does not respond to conservative treatment.
Cervical Disc Herniation Surgery
Neurosurgery
Cervical disc herniation surgery — neurosurgical decompression and stabilization for cervical disc herniation.
Evaluation of Pituitary Disorders
Internal Medicine Outpatient Services
Evaluation of pituitary disorders — comprehensive diagnosis for adenoma, hormone deficiency, and excess.
Carpal Tunnel Release
Neurosurgery
Carpal tunnel release (neurosurgery) — surgical decompression of the entrapped median nerve at the wrist.