Understanding the Various Types of Brain Tumor Surgeries

A brain tumor is often discovered after symptoms like repeated headaches, seizures, sudden weakness, vision changes, memory problems, or balance issues occur.

Brain surgery is not always the first step for every tumor, but it is one of the most common and effective treatments when the tumor is causing symptoms, growing, or needs a clear diagnosis.

What is brain surgery?

Brain surgery is a medical procedure where a neurosurgeon operates on the brain (or the structures around it) to treat a condition. For tumors, brain surgery may be performed to:

• Remove the tumor completely, if possible
• Remove part of the tumor to reduce pressure and symptoms
• Collect a tissue sample (biopsy) to identify the tumor type
• Manage complications like fluid buildup inside the brain

In simple words: brain surgery is done either to take the tumor out, reduce its effect, or confirm what it is so the right treatment can be planned.

Brain surgery is carefully planned using brain scans and other tests. Surgeons focus on “maximum safe removal,” which means removing as much tumor as possible without harming important brain functions like movement, speech, vision, or memory.

When is brain surgery needed?

Not every brain tumor requires immediate surgery. The need for surgery depends on tumor size, location, growth pattern, symptoms, and what doctors suspect about the tumor’s nature (benign vs cancerous). A neuro specialist may recommend brain surgery when:

1) The tumor is causing symptoms

Surgery may be needed if the tumor is leading to:

• Seizures
• Persistent or worsening headaches
• Weakness in an arm or leg
• Speech difficulty
• Vision problems
• Personality or memory changes
• Balance and coordination issues

Often, these symptoms happen because the tumor is pressing on nearby brain tissue or irritating parts of the brain.

2) The tumor is growing or looks aggressive

If scans show the tumor is increasing in size or has features that suggest it may be malignant, surgery is often advised sooner rather than later.

3) Doctors need a diagnosis

In many cases, the exact tumor type cannot be confirmed only from scans. A biopsy or tumor removal helps the lab identify the tumor and guide further treatment (radiation, chemotherapy, or monitoring).

4) The tumor is causing pressure or swelling

A growing tumor can raise pressure inside the skull, which can become dangerous. Surgery may be recommended to relieve pressure and protect brain function.

5) Other treatments will work better after surgery

Sometimes surgery is done first to reduce tumor volume, making radiation or chemotherapy more effective afterward.

Key goals of brain tumor surgery

• Protect brain function (speech, movement, vision, memory)
• Remove as much tumor as safely possible
• Confirm diagnosis through tissue testing
• Reduce symptoms and improve day-to-day quality of life

A skilled neurosurgeon in Hyderabad at Citizens Specialty Hospital can explain what is achievable in your specific case as “complete removal” is not always safe for tumors located near critical brain areas.

Different types of brain tumor surgeries

1) Craniotomy (open brain tumor surgery)

A craniotomy is the most common type of brain tumor surgery. The surgeon temporarily removes a small section of the skull (bone flap) to access the tumor. After removing the tumor (fully or partially), the bone is placed back and secured.

When it is used:

• Tumors that are accessible and safe to reach directly
• Tumors causing major symptoms or pressure
• Tumors that need maximum removal for best results

Why it’s helpful:

• Allows better control and visibility for tumor removal
• Often offers significant symptom relief by reducing pressure

2) Awake craniotomy (surgery near speech or movement areas)

If a tumor lies near areas that control speech or movement, the surgeon may perform an awake craniotomy. The patient is awake for a portion of the procedure so the team can check speech or limb movement in real time.

When it is used:

• Tumors near language, movement, or other “high-risk” brain areas

Why it’s helpful:

• Helps reduce the risk of long-term speech or movement problems
• Supports safer tumor removal in sensitive locations

3) Stereotactic biopsy (image-guided needle biopsy)

Sometimes the safest first step is a biopsy, especially for deep tumors or tumors near critical structures. A stereotactic biopsy uses CT/MRI guidance to precisely reach the tumor through a small opening and collect tissue.

When it is used:

• Deep or hard-to-reach tumors
• Cases where open surgery is too risky initially
• When diagnosis is needed before planning treatment

Why it’s helpful:

• Minimally invasive compared to open surgery
• Gives a clear diagnosis with a shorter recovery time

4) Endoscopic brain surgery (minimally invasive “camera-assisted” surgery)

Endoscopic surgery uses a thin tube with a camera (endoscope). In selected cases, surgeons can reach a tumor through smaller openings, sometimes even through natural pathways like the nose.

Common examples:

• Tumors near the pituitary gland (often approached through the nose)
• Tumors inside fluid spaces of the brain (ventricles), depending on location

Why it’s helpful:

• Smaller incisions, often less pain and faster recovery
• Shorter hospital stay for selected cases

5) Laser interstitial thermal therapy (LITT)

LITT uses a thin probe placed into the tumor under imaging guidance. The probe heats and destroys targeted tumor tissue.

When it may be considered:

• Small tumors
• Tumors in difficult locations
• Certain recurrent tumors
• Patients who may not be ideal candidates for open surgery

Why it’s helpful:

• Less invasive than a craniotomy
• Often shorter recovery time in suitable patients

6) Procedures to treat fluid buildup (CSF diversion)

Some tumors block normal fluid flow in the brain, causing hydrocephalus (fluid buildup), which raises pressure and worsens symptoms. In such cases, surgery may be needed to divert fluid and relieve pressure.

Common procedures:

• Ventriculoperitoneal (VP) shunt
• Endoscopic third ventriculostomy (ETV)

These may be done before tumor removal, along with tumor surgery, or afterward—depending on urgency and tumor location.

Conclusion

There are several approaches to brain tumor surgery, including craniotomy, awake craniotomy, stereotactic biopsy, endoscopic procedures, laser-based techniques, and fluid-relief surgeries when needed. The right choice depends on tumor location, symptoms, and what is safest for brain function. Recovery time after brain surgery may range from a few weeks to several months, and rehabilitation can be an important part of regaining independence.