Performing Brain Surgery

• Prior to surgery, the patient may undergo CT scanning or MRI scanning to link with operating room computers.
• The patient is usually induced into general anesthesia. A few brain operations performed in very important regions of the brain are performed with the patient sedated but awake.
• Hair in the region of surgery may or may not be shaved.
• The scalp is cleaned and prepared for surgery. The area is draped off in a sterile fashion.
• An incision is made through the scalp. Plastic clips are placed on the scalp edges to stop vigorous bleeding.
• Holes are created in the skull with very a high-speed drill. The holes are connected with a foot-plated router attached to the drill. A window of bone is removed and kept in antibiotic soaked sponges.
• The bag of fluid (the dura) in which the brain is contained is carefully opened exposing the underlying bone.
• Depending on the surgery required, the brain is either entered or retracted to reach the problem area.
• An operating microscope is often brought in to assist.
• Computer systems linked to MRI images of the patient’s brain are often used to help find the problem area.
• The problem area is addressed.
• Once the principle part of the surgery is complete (a tumor is removed), the region of surgery is washed with antibiotic containing fluid, and is lined with anti-bleeding materials.
• The bag of fluid is closed over the brain.
• The skull is replaced and secured with small metal plates and screws.
• The scalp is closed up and dressed in a sterile fashion.
• The patient is awakened from surgery.
• They then go to a surgery recovery room or directly to the ICU.