Neurosurgery is often the first step in managing glioblastoma, with the goal of removing as much of the tumor as possible while preserving healthy brain tissue. At the Department of Neurosurgery, we are committed to providing compassionate, patient-focused care. Our team of 23 neurosurgeons, including leaders in glioblastoma treatment, works to ensure that every patient feels supported and informed throughout their journey. With a focus on clear communication, personal attention, and advanced surgical techniques, we strive to make the treatment process as comfortable and effective as possible.
Brigham and Women’s is proud to offer the Advanced Multimodality Image-Guided Operating (AMIGO) Suite, a leading-edge facility that enhances the precision of glioblastoma surgeries. The AMIGO Suite integrates advanced imaging technology directly into the operating room, allowing surgeons to visualize tumors in real time. This enables highly accurate removal of tumor tissue while minimizing risk to critical areas of the brain. By combining advanced imaging with expert surgical skill, AMIGO helps provide personalized, effective treatment options. This innovative resource sets a new standard for neurosurgical oncology in New England and beyond.
Resection Surgery: One of the primary surgical treatments for glioblastoma is tumor resection. This procedure involves performing a craniotomy, where a portion of the skull is temporarily removed to access the brain. The goal is to remove as much of the tumor as possible while avoiding harm to surrounding healthy tissue. While complete tumor removal is rare due to the infiltrative nature of glioblastoma, skilled neurosurgeons work carefully to achieve the best possible outcome. Their expertise plays a key role in how much of the tumor can be safely removed.
Debulking Surgery: In cases where complete resection is not feasible, debulking surgery may be performed. This procedure focuses on removing a significant portion of the tumor to alleviate symptoms such as pain and pressure caused by the tumor’s presence. Reducing the size of the tumor can also enhance the effectiveness of treatments like radiation therapy and chemotherapy. While debulking surgery may not cure glioblastoma, it is an important step in improving the patient’s quality of life and making additional therapies more effective.
Shunt Placement and Revisions: Glioblastomas can sometimes block the normal flow of cerebrospinal fluid (CSF), causing increased pressure in the brain, a condition known as hydrocephalus. To address this, neurosurgeons may place a temporary external drain or a permanent internal shunt. The shunt redirects excess CSF to the abdomen, where it is absorbed by the body. If a shunt stops working properly, a revision may be needed to restore its function and relieve pressure on the brain.
Awake Surgery and Brain Mapping: For tumors located near critical brain regions, awake surgery combined with brain mapping may be necessary. During this procedure, patients remain awake for part of the surgery to help the neurosurgeon identify areas responsible for essential functions like movement and speech. This ensures that the tumor can be removed safely while protecting vital brain functions. The awake portion of the surgery is carefully planned to be painless and comfortable for the patient.
Intraoperative Fluorescence: Intraoperative fluorescence is another advanced technique used in glioblastoma surgeries. Patients take a compound called 5-ALA before surgery, which causes tumor cells to fluoresce under a special light during the procedure. This allows surgeons to clearly differentiate between cancerous and healthy tissue, helping to maximize tumor removal while minimizing harm to the brain.
Before surgery, patients will meet with their care team at the Roberta and Stephen R. Weiner Center for Preoperative Evaluation. During this appointment, necessary tests will be performed and instructions for preparing for the procedure will be provided. Patients are encouraged to ask questions and ensure they fully understand what to expect. Planning ahead is essential, including arranging transportation to and from the hospital and preparing for recovery at home. A social worker is available to assist with post-surgery care arrangements if needed.
On the day of surgery, a specialized team of surgeons, anesthesiologists, and nurses will ensure patients receive expert care in the operating room. After the procedure, patients will be moved to a post-surgical care unit, where they will be closely monitored and cared for by experienced staff. The length of the hospital stay typically depends on the type of surgery and the patient’s recovery progress, with most craniotomy patients staying a few days.
Recovery times vary based on the type of surgery and individual patient factors. Patients may experience fatigue and pain at the incision site, and they will be advised to avoid strenuous activities during the initial recovery period. Pain management options will be discussed with the care team. Returning to normal activities, including work, will depend on the patient’s progress and the advice of their surgeon. The care team will remain available to answer questions and provide guidance throughout the recovery process.
Following surgery, patients may benefit from neurological rehabilitation to restore function and improve overall well-being. Rehab programs are designed to help manage symptoms, enhance recovery, and increase independence after treatment.
At Brigham and Women’s Hospital, the NeuroRecovery Clinic helps patients recover and adjust after brain cancer surgery. Our expert team partners with specialists in Physical Medicine and Rehabilitation to offer personalized care that supports healing, improves function, and helps patients return to daily life. With a focus on advanced research and individualized care, we work to help each patient rebuild confidence and regain as much independence as possible.
Our multidisciplinary team of glioblastoma specialists will formulate a detailed treatment plan including non-surgical treatment options, such as chemotherapy, radiation therapy, immunotherapy and targeted therapy. Your care team will work to control the spread of your cancer and manage your symptoms.
Learn more about non-surgical options for glioblastoma.
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