Brain surgery refers to any operation on the brain. It is almost always a major surgery due to the brain’s delicate and highly complex structure. There are several types of brain surgery. Recovery depends on the type of brain surgery, but it may be a slow process.

Craniotomy is one of the most common types of brain surgery. Doctors use it to treat a variety of conditions. It involves temporarily removing a portion of the skull so a surgeon can operate on the brain.

People undergoing brain surgery usually work with a neurosurgeon and sometimes work with other experts, such as oncologists, radiation oncologists, physical therapists, and vascular surgeons.

Keep reading to learn more about brain surgery, the different types, and what to expect.

Share on Pinterest
VICTOR TORRES/Stocksy

Brain surgery refers to a wide range of medical procedures on the brain. Some procedures, such as a brain biopsy, are relatively minor and have a short recovery time. Others, such as craniotomy, may require weeks to months of recovery.

Brain surgery happens in an operating room, usually under the guidance of a neurosurgeon.

A person will be under anesthesia, so they will not feel anything. In certain cases, a person will be awake during brain surgery.

People need brain surgery for many different reasons. They can include:

The most common types of brain surgery include:

Brain biopsy

If brain scans suggest that there is an unusual growth in the brain, a doctor may recommend a brain biopsy.

This removes a small piece of brain tissue so a lab can examine it. A brain biopsy usually involves inserting a tiny needle into the brain to withdraw tissue.

Craniotomy

A craniotomy is the surgery of choice for many different brain issues, especially cancer and other growths.

After cutting into the skull, a doctor can perform a variety of brain procedures, such as repairing damaged blood vessels or removing harmful growths.

Deep brain stimulation

Deep brain stimulation involves inserting electrodes along the brain to stimulate specific regions.

A person will also have a pulse generator on their chest.

Posterior fossa decompression

This procedure involves operating on the cerebellum or brain stem.

It usually requires making an incision on the back of the head, and it can relieve pressure on the brain.

Thrombectomy

Thrombectomy is surgery to remove clots — or blockages — in blood vessels in or around the brain. It does not typically require removing part of the skull. Instead, a doctor threads a tube through a blood vessel and into the targeted vein or artery.

A person may need this procedure after a stroke.

Neuroendoscopy

Neuroendoscopy means using an endoscope to perform surgery. This is a type of minimally invasive procedure where a doctor threads a long camera through the nose.

Doctors use it most often to remove tumors of the pituitary gland, which is just behind the nose.

The risks that accompany brain surgery vary depending on the type of surgery a person has. In general, they include:

People may also die as a result of brain surgery.

Ask a healthcare professional about the likelihood of various side effects and whether there is anything a person can do to mitigate possible risks before undergoing brain surgery.

A preassessment appointment with a doctor will ensure that a person is prepped and fit for the surgery. This usually involves tests to measure a person’s general health.

Before surgery, the doctor might advise someone on the following:

  • which medications they can still take or should avoid
  • whether to stop smoking, if applicable
  • how long they may stay in the hospital
  • whether ongoing support from family members or a home health aide is necessary
  • whether head shaving is necessary
  • whether fasting is necessary

A person may wish to take certain items with them to help make their stay in the hospital more comfortable, such as headphones or magazines. They may also want to check whether their family and friends are able to visit them during their stay.

Just prior to surgery, people should expect to:

  • avoid food and drink the night before
  • change into a hospital gown
  • make preparations for the surgery, such as washing the hair with special soap
  • be put to sleep with anesthesia

The surgical procedures vary greatly depending on the type of brain surgery.

Some surgeries may require a hole in the skull, while others may not.

In most cases, a person will be asleep and unaware during surgery. An anesthesiologist will give medication through a vein to help a person relax and go to sleep. A person will have no memory of the surgery.

Awake brain surgery

In some cases, especially if a doctor is operating on areas of the brain that affect speech or communication, a person may need to be awake during surgery.

An anesthesiologist will give numbing medication. During the surgery, a person may expect to:

  • hear sounds such as drilling
  • feel pressure on the head
  • interact with the surgeon

The brain does not have pain receptors. So even if a person is awake during surgery, they will not feel pain in the brain.

People generally need to stay in the hospital for monitoring after brain surgery. The length of the stay, usually 3–10 days, can vary.

Typically, a healthcare professional will regularly monitor a person who has just had brain surgery. Immediately after surgery, people might experience the following:

  • swelling
  • pain
  • weakness
  • pressure at the incision site, if one exists
  • confusion
  • seizures
  • speech problems

However, medications may help reduce or prevent some of these effects.

After surgery, a person will meet with their neurosurgeon, and possibly with other medical professionals. They will develop a recovery and assessment plan. In most cases, a person may require rehabilitation and care to enable them to perform everyday tasks, such as walking.

There is no set recovery time or process for all brain surgeries. In many cases, a person will need to wait several weeks before driving and doing other complex activities.

A person may need ongoing care during the recovery period. This can include:

Some factors that affect recovery include:

  • Types of surgery: Recovery typically depends on the type of surgery. For example, a brain biopsy requires almost no recovery time, while a craniotomy usually takes 1–2 months or longer to recover from.
  • A person’s general health status: The underlying medical condition that requires surgery will affect recovery. For example, a stroke survivor may need to recover from both surgery and the stroke itself.
  • Surgical complications: A person may need longer to recover if they experience surgical complications such as bleeding or infection.

Even major brain surgery has a high survival rate and a low risk of complications. When a doctor recommends brain surgery, it is because the risks of not having surgery outweigh the risks of having it.

A person should ask about the risks and benefits of surgery, potential complications, recovery time, and likelihood of success. Getting a second opinion may offer additional insight, as well as peace of mind that a person is making the right decision.