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There are over 120 types of brain tumour – glioblastoma (GBM4), meningioma, astrocytoma, and glioma are just a few of the names. In some cases brain surgery is necessary; in others it may just be question of watch and wait. But you need to know what the best course of action is.

Discover the brain tumour support and advice we can give  

Brain Tumour Surgery (Neurosurgery)

On this page you will find lots of information about different types of brain tumour surgery, to help you know what to expect.

I have a far better idea of what to ask my consultant when I next see him and what the long term implications will be. This has given me more sense of not only an understanding of my situation, but I feel like I have regained some control of the situation and my life again.


I really cannot thank-you enough for your help with this. I had no idea where to turn or what to do and although there is still very much a long way to go and many decisions to be made, which will no doubt be hard, I feel better prepared and feel that if I need help I am not alone, but that I can turn to you.


Thank-you, from the very bottom of my heart,

Nadia, brain tumour patient, London


Brain surgery. Scary words. If you are reading this then it is highly likely you have recently learnt that you are going to have neurosurgery. This is one of the first major decisions you will face. In fact, I don’t think there is anything as frightening as facing this decision – ever. If you can make this decision – one way or the other – then nothing you do will ever be as scary as this.


But you are not facing this alone. You will have a brilliant team behind you, your family will be there and of course, brainstrust is just a call away.


No decision is going to be straightforward. It’s all a balance of risk v. benefits and the truth is that there is seldom a good reason to remove a brain tumour unless it is thought  that the vast majority can be removed. Partial resection can sometimes be a bad thing. What we’re saying here is that each case needs to be decided individually; so much depends on your quality of life, type of brain tumour, where it is. The list goes on. 


First decision – whether to proceed with an attempted complete surgical removal or whether to have just a biopsy. Evidence shows that wherever possible it is better to resect as much as is possible. Surgery to remove a tumour, even malignant ones, has several advantages over a biopsy:

  • By removing tumour mass, room can be made to allow for the swelling of brain tissue which occurs both with radiation therapy and if the tumour recurs.
  • The more that can be taken out, the less that will need to be treated with other forms of therapy.
  • More tumour to diagnose, means better accuracy of the diagnosis and grading, because there are more cells to examine.


Everything depends on the individual’s well being, the nature of the tumour, and potential complications. All of these must be talked through and thought about. And thought about some more. But don’t think for too long. It can be very wearying and will occupy your head so that in the end you will not feel able to make a decision. And no decision is irreversible – until you go down to the operating theatre.


Here is a really clear video which explains about why you might need surgery, what the different types of surgery are and what happens after surgery. It is Australian – so just make allowances for differences in our healthcare systems. And one day we will make our own!

Types of neurosurgery

Image Guided Craniotomy

This is the most generally used procedure, which involves removing a piece of skull and then replacing it, under a general anaesthetic. It is called a craniotomy because this procedure removes part of the cranium – the skull. And image-guided refers to the use of scans and a computer to precisely locate and target a lesion within the brain. All craniotomies for brain tumours are image guided.


Nowadays your scan can be performed in advance of your surgery (without a frame on), the data is uploaded onto a computer in the operating room, and a navigation system is used to locate the tumour (frameless stereotaxy or image-guidance). This technique is beneficial because it localises the tumour, so the operation is shorter and the area of the head that the surgeon must disrupt is often smaller.


Find out more about image guided craniotomy - click here.

Awake Craniotomy

An awake craniotomy is an operation performed in the same manner as a 'conventional' craniotomy but with the patient awake during the procedure.


Find out more about awake craniotomy - click here.

Intraoperative MRI - Craniotomy with real time MRI

This is what enabled Meg to have her surgery. This technology has been around for about twenty years in the USA and was pioneered by Prof. Peter Black. It is now available in the UK. For more information about availability speak to brainstrust.

Read more about Intraoperative MRI - click here


Lasers in brain surgery

This is a new technique and sometimes using lasers can help to remove a brain tumour. It does require opening the skull and is used during a craniotomy. It is still experimental and is not available in the UK.

Read more about lasers in brain surgery - click here

Preparing for neurosurgery – a timeline

Hopefully you will have time to get your head around the fact that you are going to have neurosurgery. It is scary but you need to remember that neurosurgeons perform hundreds of these operations each year. This timeline can help you prepare.

Read more about preparing for neurosurgery. Click here. 

Back to brain tumour treatment information

Resources used to create this page:

Patient/carer representative

Consultant Neurosurgeon

National Institute for Health and Clinical Excellence guidelines – Improving Outcomes Guidance Brain and CNS Tumours 2006

Living with a Brain Tumour  (Peter Black) 2006

Fast Facts – Brain Tumors (Abrey and Mason) 2009

Primary Central Nervous System Tumors – pathogenesis and therapy (Current Clinical Oncology, Humana Press 2011

Navigating Life with a Brain Tumour, L. Taylor, F. Alyx B. Umphrey, D. Richard (2013)


Date published: 17-05-2009   Last edited: 16-10-2014   Due for review 31-09-2016 brainstrust - information standard accredited brain tumour information

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