Surgery is a common treatment for many types of brain tumors. It is often the first course of treatment. For some slow-growing tumors, it may be the only treatment you need. Neurosurgeons at the Malnati Brain Tumor Institute of the Lurie Cancer Center at Northwestern Memorial Hospital use the most advanced techniques to perform more brain tumor surgeries than any other team in Chicago.

Surgery may help to:

• Fully remove the tumor, if possible
• Relieve your symptoms
• Remove a small piece of the tumor to tell what type of tumor you have
• Place a small tube, called a shunt, in the area around your brain or spine

The type of surgery you may need depends upon:

• The type of tumor
• The size and location of the tumor
• How much pressure the tumor is placing on vital areas of your brain
• If the tumor can be fully removed

If you need surgery, your neurosurgeon will remove a small piece of your skull to access your brain tumor. This procedure is called a craniotomy. They will replace the piece of skull at the end of the surgery. You may be asleep through most of the surgery. But, if your surgeon needs to check your brain function, you may need to be awake for part of the surgery.

Brain tumors can be removed through surgery in several ways. Your surgeon may:

• Cut the tumor out with a scalpel or surgical scissors
• Use a vacuum device to remove the tumor if it is very soft
• Use a tool to liquefy the tumor, and then vacuum it out
• Use a laser to kill cancer cells if they cannot reach the tumor with regular surgery

Your neurosurgeon will try to remove the whole tumor, if possible. If your team cannot remove all of the tumor without harming your brain, they will take out as much as they can. This is called debulking surgery. Reducing the size of a tumor through surgery can help lower the pressure on the brain or spine. This can relieve some of your symptoms.

Leading-edge surgical care

Northwestern Medicine is home to skilled neurosurgeons trained in the latest techniques, including:

• Intraoperative MRI (iMRI): Northwestern Medicine Central DuPage Hospital is the only hospital in Illinois to offer full-field intraoperative MRI. This state-of-the-art surgical technology provides high-quality, more detailed imaging during surgery. By integrating this technology with advanced surgical techniques, your neurosurgeon can conduct scans during surgery. This allows them to remove brain tumors more safely and precisely, especially around sensitive parts of the brain. This lets them remove as much of the tumor as possible. It also reduces how much healthy tissue they remove.
• Gamma Knife® radiosurgery: This advanced cancer treatment is used in multidisciplinary care plans. Gamma knife® is offered downtown at the Lou and Jean Malnati Brain Tumor Institute at Northwestern Memorial Hospital and the Northwestern Medicine Cancer Care Center Warrenville. Gamma Knife® radiosurgery is often used to treat brain tumors in difficult locations. It tends to cause less damage to surrounding healthy tissue. This safer treatment can be an option for benign, malignant, recurrent or metastatic brain tumors.
• Endoscopic skull base surgery: This surgery removes benign and cancerous tumors on the base of the brain or skull. It involves using minimally invasive endoscopes to access hard-to-reach areas.
• Awake craniotomy: A craniotomy is a type of surgery where a piece of the skull is temporarily removed to access the brain. The patient is woken up during surgery. This reduces the risk of damaging critical areas of the brain that control speech, language and motor other skills.
• Functional MRI: This is a non-invasive pre-surgical tool used to assess the location of the brain tumor and its impact on the brain so a neurosurgeon can safely remove it.
• Clinical trials: Northwestern Medicine offers a number of surgical-based clinical trials for people with brain tumors.