The surgical treatment will be aimed mainly at total extirpation of the tumor. Where radical removal is not possible, the goal will be to achieve a comprehensive resection compatible with a good functional result. For a number of tumor types, the patient's prognosis depends on a tumor resection as complete as possible. In such cases, a new MRI examination is performed immediately after the tumor operation in order to evaluate the radicality of the operation and to evaluate the possible need for a reoperation.
It is often necessary to limit the surgical procedure when aimed at tumors that arise from and infiltrate the brain tissue. It will not be to the advantage of either the patient or the relatives if radical surgery destroys brain functions or the entire personality is obliterated. The goal is to try and remove enough of the tumor, and at the same time, not too much.
- Craniotomy with resection
- Transphenoidal resection
- Endoscopic resection
Use of different preoperative and intraoperative aiding tools makes it possible to perform more radical resections, with good functional results.
- MR images in three levels
- Ultrasound aspirator
- Intraoperative ultrasound
- Functional MRI
- Awake craniotony with cortical and subcortical stimulation
Such systems can be used to plan the best surgical approach to the tumor. The aim is not just to find these tumors more easily, but also to better define the tumor's boundaries thereby achieving total extirpation more frequently.
In principle, the new navigation systems can be divided into two main groups; those based on preoperative images (MRI, CT), and those based on intraoperative images (MRI, ultrasound). The advantage of intraoperative image registration is that corrections are made for the dislocation of the brain that occurs during the operation ("brain shift"), which should allow a better surgical radicality.
Hydrocephalus is a significant problem for many patients with intracranial tumors and requires surgical treatment itself.