Uncovering the Risks and Complications of Brain Surgery

Introduction

Brain surgery, also known as neurosurgery, is a life-saving procedure that has the power to address a range of conditions, such as brain tumors, aneurysms, and epilepsy. Thanks to incredible advancements in the medical field, brain surgery is now safer than ever before. However, it’s important to note that there are still risks and complications involved. By understanding these potential hazards and taking preventative measures, we can increase the chances of a successful outcome. Let’s explore the world of brain surgery and discover the most common risks and complications with UpSurgeOn.

There are several types of brain surgery, each with its own purpose and approach. Discover more about the most common types of brain surgery HERE

Risks and complications of brain surgery 

Brain surgery is a complex and delicate procedure that carries a variety of risks and complications. While advances in medical technology have made the procedure safer than ever, neurosurgery is still considered a major medical event with the potential for serious complications [1]. Some of the risks and complications associated with brain surgery include:

• Loss of function: Brain surgery carries a significant risk of loss of function, such as impaired speech, mobility, or cognitive abilities, due to potential damage to the brain. The extent of these risks varies with several factors, including the type of surgery, the location of the surgery in the brain, and the overall health of the patient.
• Problems with speech, memory, and other functions: Problems with speech, memory, muscle weakness, balance, vision, coordination, and other functions may occur after brain surgery. Depending on the extent of the damage, these problems may be temporary or permanent [2].
• Bleeding, blood clots, and infection: As with any surgery, the risk of bleeding, blood clots and infection exists during and after brain surgery. An infection in the brain can lead to complications such as swelling and further damage to the brain [2 – 4].
• Brain swelling: Neurosurgery may cause the brain to become inflamed and swollen, increasing pressure inside the skull and potentially damaging brain tissue [3].
• Allergic reactions: Allergic reactions to anesthesia or other medications used during the procedure may occur in some patients [3].  Although allergic reactions to anesthesia are rare, they can occur. Some patients may be more susceptible due to their medical history or pre-existing conditions [5] [3]. 
• Coma: A patient may enter a prolonged period of unconsciousness called a coma or sometimes a vegetative state if brain surgery is unsuccessful. A coma is a state of complete unconsciousness with no eye opening, while a vegetative state (VS) is a state of complete unconsciousness with some eye opening and periods of wakefulness and sleep. However, most brain surgeries have a high success rate and the incidence of these complications is low. [4].
• Excess cerebrospinal fluid (hydrocephalus): Brain surgery can interfere with the normal flow and absorption of cerebrospinal fluid, causing fluid to build up in the brain. This condition, known as hydrocephalus, may require additional treatment [2].
• Need for more surgery: In some cases, brain surgery may not completely resolve the underlying problem. Additional surgeries may be needed. Factors such as thrombocytopenia, hypertension, emergency surgery, severity of the underlying condition, infection, and incomplete resolution of the underlying problem may increase the risk of needing additional brain surgery after the initial surgery [6] [7].
• Anesthesia and surgery risks: The general risks associated with anesthesia and surgery, such as reactions to medications, breathing problems, and blood clots, also apply to brain surgery [2] [8].

It’s important to note that not all patients will experience these complications, and the success of brain surgery varies depending on the type of procedure and the patient’s general health at the time of surgery. As a neurosurgeon, you must explain the risks and benefits of surgery to your patients before the procedure. This allows them to make an informed decision about their health.

Long-term side-effect of Brain Surgery 

Long-term side effects of brain surgery can vary depending on the type of procedure, the location of the tumor, and the patient’s overall health. Some possible long-term side effects include:

• Cognitive dysfunction: Brain surgery can cause cognitive impairment, such as problems with memory, attention, processing speed, and executive function. These problems can persist or worsen over time, affecting a patient’s quality of life and ability to perform daily tasks. [9 -12].
• Emotional and personality changes: Changes in a patient’s emotional state and personality can sometimes occur after brain surgery. These changes may include increased irritability, impulsiveness, moodiness, and difficulty in social interactions [13] [14].
• Neurological deficits: Some patients may experience long-term neurological deficits such as weakness, balance problems, tremors, or vision loss. These issues may require ongoing rehabilitation and support, as they can affect a patient’s ability to function independently. [2] [10] [15].
• Seizures: Brain surgery, especially if performed near areas of the brain responsible for seizure activity, may increase the risk of seizures in some patients. [12] [15].
• Infections: While rare, infections can occur after brain surgery, even after years. These infections may be a reason for additional treatment, such as antibiotics or additional surgery [16].
• Fatigue: Fatigue is a common side effect of brain surgery and can be a contributing factor to cognitive difficulties and impairments in daily functioning. This fatigue can last for a long time, even more than a year after surgery [11] [17].
• Hydrocephalus: As mentioned above, brain surgery can disrupt the normal flow and absorption of cerebrospinal fluid, causing fluid to build up in the brain. This condition, which is known as hydrocephalus, may require additional treatment. [16].

It’s worth keeping in mind that not every patient will encounter these enduring side effects, and the intensity of these effects can differ significantly among individuals. By collaborating with medical experts and implementing consistent rehabilitation techniques, as a neurosurgeon, you can effectively address and alleviate the negative impacts of treatment, ultimately resulting in a remarkable enhancement of the patient’s overall well-being and recuperation.

Conclusion

Brain surgery, a highly intricate and potentially life-altering procedure, holds the key to treating a multitude of brain-related conditions. Although the risks and complexities associated with this surgery cannot be ignored, the remarkable advancements in medical technology and the exceptional expertise of neurosurgeons have significantly enhanced its safety. UpSurgeOn, a pioneer in surgical simulation technologies, has dedicated itself to empowering medical professionals to carry out their missions with unwavering confidence, unparalleled precision, and exceptional skill. Join us on an extraordinary journey to uncover the transformative potential of surgical simulation with UpSurgeOn, and stay at the forefront of the ever-evolving realm of surgery!

References: 

1. Brain surgery: MedlinePlus Medical Encyclopedia. (n.d.). https://medlineplus.gov/ency/article/003018.htm
2. The Brain Tumour Charity. (2023a, June 1). Neurosurgery side effects | The Brain Tumour Charity. https://www.thebraintumourcharity.org/brain-tumour-diagnosis-treatment/treating-brain-tumours/adult-treatments/side-effects-brain-tumour-treatment/side-effects-neurosurgery/
3. Anesthesia risk Assessment | Made for this moment. (n.d.). Made for This Moment | Anesthesia, Pain Management & Surgery. https://www.asahq.org/madeforthismoment/anesthesia-101/types-of-anesthesia/anesthesia-risks/
4. Problems after brain tumour surgery. (n.d.). https://www.cancerresearchuk.org/about-cancer/brain-tumours/treatment/surgery/recovering
5. The Healthline Editorial Team. (2019, March 20). Can I be allergic to anesthesia? Healthline. https://www.healthline.com/health/anesthesia-allergy
6. Liu, Y., Wu, H., Li, H., Dong, S., Liu, X., Li, K., Du, C., Meng, Q., & Zhang, H. (2021). Severity Grading, Risk Factors, and Prediction Model of Complications After Epilepsy Surgery: A Large-Scale and Retrospective Study. Frontiers in Neurology, 12. https://doi.org/10.3389/fneur.2021.722478
7. Craniotomy. (2022b, April 26). Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/craniotomy
8. Surgeon, R. R. E. H. a. N. (2021, May 17). How dangerous is brain surgery? 5 types. MedicineNet. https://www.medicinenet.com/how_dangerous_is_brain_surgery/article.htm
9. Cognitive Remediation after brain tumor surgery | Brain & Spine Center. (n.d.). Weill Cornell Medicine.https://weillcornellbrainandspine.org/condition/brain-tumors-adults/cognitive-remediation-after-brain-tumor-surgery
10. Monje, M., & Fisher, P. G. (2011). Neurological complications following treatment of children with brain tumors. Journal of Pediatric Rehabilitation Medicine, 4(1), 31–36. https://doi.org/10.3233/prm-2011-0150
11. The Brain Tumour Charity. (2023a, February 10). Cognition and learning difficulties | The Brain Tumour Charity. https://www.thebraintumourcharity.org/living-with-a-brain-tumour/side-effects/cognition-and-brain-tumours/
12. Dhandapani, M., Gupta, S., Mohanty, M., Gupta, S., & Dhandapani, S. (2016). Trends in cognitive dysfunction following surgery for intracranial tumors. Surgical Neurology International, 7(8), 190. https://doi.org/10.4103/2152-7806.179229
13. Campanella, F., Fabbro, F., Ius, T., Shallice, T., & Škrap, M. (2015). Acute effects of surgery on emotion and personality of brain tumor patients: surgery impact, histological aspects, and recovery. Neuro-oncology, 17(8), 1121–1131. https://doi.org/10.1093/neuonc/nov065
14. Jenkins, L. M., Drummond, K. J., & Andrewes, D. (2016). Emotional and personality changes following brain tumour resection. Journal of Clinical Neuroscience, 29, 128–132. https://doi.org/10.1016/j.jocn.2015.12.007
15. Zetterling, M., Elf, K., Semnic, R., Latini, F., & Engström, E. R. (2020). Time course of neurological deficits after surgery for primary brain tumours. Acta Neurochirurgica, 162(12), 3005–3018. https://doi.org/10.1007/s00701-020-04425-3
16. Gürbüz, M. S., Çelik, Ö., & Berkman, M. Z. (2012). Infection of cranioplasty seen twenty years later. Journal of Korean Neurosurgical Society, 52(5), 498. https://doi.org/10.3340/jkns.2012.52.5.498
17. Cancer Council NSW. (2023, February 21). Side efects of surgery for brain cancer | Cancer Council NSW. https://www.cancercouncil.com.au/brain-cancer/treatment/surgery/side-effects-of-surgery/