To remove part of, or all of the tumour, you need an operation called a craniotomy. You will usually have a general anaesthetic. During the operation, the surgeon cuts the scalp and removes a piece of the skull over the tumour. They use specialised instruments and a powerful microscope to look at the brain. This means they can carefully remove the tumour without taking healthy areas of the brain.
After removing part of, or all of the tumour, the surgeon replaces the piece of skull and uses stitches or staples to close the scalp. Sometimes the surgeon uses keyhole surgery which is done through a smaller opening in the skull. They use an instrument called a neuroendoscope. This is a thin, flexible tube with a camera on the end and an eyepiece to look through. The surgeon attaches special instruments to the neuroendoscope to remove the tumour. They will explain whether this is suitable in your situation.
If it is not possible to remove the whole tumour, the surgeon will remove as much of it as they can. This is sometimes called a partial resection or debulking.
After the operation, the tissue is sent to a laboratory to be examined by a pathologist.
Craniotomy while you are awake
Sometimes the surgeon will suggest that you have a craniotomy while you are awake. This may sound frightening but people usually cope well with it. Because you are awake, the surgeon can check that your speech and movement are not being affected by the surgery.
Usually you are given sedation or a general anaesthetic for the first part of the surgery. The surgeon uses local anaesthetic injections to numb the scalp. They gently wake you when they are ready to operate on the brain. The brain has no nerve endings so you shouldn’t feel any pain during the operation.
You can see the doctors and nurses and talk to them while you are awake. They will ask you questions and check your speech or movement. If anything changes, the surgeon will stop operating and assess the situation.