A lesionectomy is an operation to remove a lesion — a damaged or abnormally functioning area — in the brain. Brain lesions include tumors, scars from a head injury or infection, abnormal blood vessels, and hematomas (a swollen area filled with blood).
Lesionectomy is the surgical removal of lesions. Its purpose is to stop epilepsy and seizures. Recovery depends on the location and size of the lesion. The surgery records a high percentage of success rate with side effects that can fade off with time.
Lesions are small structural abnormal or damaged parts of the brain. These damaged areas are relatively small. They can be scars resulting from trauma to the head like head infections, injuries, or they can be brain tumors and others such as swollen and abnormal blood vessels and hematomas (blood mass in an area of the brain). Lesions often lead to abnormal functions of the brain such as seizures, epilepsy, etc. There are two types of lesions and they include:
Congenital (Birth Defect) Lesions
These damages to the brain are malformations that occur in a baby before birth. These lesions may be:
These are lesions that are developed after birth and can result from the following:
- Vascular (venous) abnormalities such as arteriovenous malformation, angiomas, cavernous malformation.
- Cortical dysplasia, which is a result of the abnormal folding in the brain or the cellular migration that happens during the brain development of a fetus.
Lesions can be managed and treated, and this is through a surgical procedure called “lesionectomy”.
WHAT IS LESIONECTOMY?
Lesionectomy is a surgery used to remove lesions (abnormality) from the brain. The surgical procedure involves the removal of the damaged part and its surrounding brain tissue that is causing seizures. A lesionectomy can be achieved through the following methods:
A traditional surgical method that involves opening up the part of the skull where the lesion is located and using operational tools to remove the lesion.
- Trauma to the brain resulting in brain injuries.
- Brain tumors such as gangliogliomas, astrocytomas, dysembryoplastic neuroepithelial tumor (DNET)
A less invasive method that involves creating smaller openings on the brain and gaining access into the brain by using tiny surgical probes through the small burr holes in the skull. The surgical probes (endoscope and laser) are guided by MRI and are used to burn and remove the lesions.
REASONS FOR LESIONECTOMY
Lesionectomy is a surgery done for the following reasons:
- Minimally Invasive Epilepsy Method
WHO IS A CANDIDATE OF LESIONECTOMY?
Before a lesionectomy is recommended for a patient, some factors makes the patient eligible for the surgery, and they include:
- To remove brain tumors
- To remove scars from brain trauma and injuries.
- To reduce swollen and abnormal blood vessels.
- To remove hematomas, which are gathered blood mass in an area of the brain.
As a surgery, lesionectomy follows a set of procedures.
Before the Surgery,
You will have to undergo some imaging scans such as MRI and EEG to know the location of the lesion and to determine if it is the cause of seizures. After these are determined and you are declared fit and safe for lesionectomy, a date can be fixed for your surgery.
During the Surgery,
On arrival at the operation room, the area of the head (brain) to be operated on will be shaved clean of any hair. Thereafter, you will be given anesthesia to keep you in a painless state but awake. This is so that you can be told to use certain parts of your senses and body to help the doctor identify which part of your brain controls what and to make sure the surgery goes smoothly without causing harm to these parts.
The procedure “craniotomy” is carried out through the following steps will be taken:
- If the child’s epileptic condition is linked to a lesion.
- If the seizures from the lesion can no longer be controlled by medications.
- Lesionectomy can only be carried out if the lesion and the surrounding damaged brain tissues can be removed without causing harm to other areas of the brain that have vital functions such as hearing, language, memory, language, smell, etc.
- There has to be a greater chance that the child with benefit from the operation without serious complications.
After the Surgery,
You will be moved to your recovery room to recuperate. Painkillers will also be administered to you through IV drips to curb the pains. You will be required to stay in the hospital for at least 3 to 5 days for monitoring and observation, to make sure there are no problems and then you can be considered fit to leave.
You will still be placed on medications for the pains, antibiotics to fight infections, and may be required to continue antiseizure medications till your seizure control is established.
Recovering from lesionectomy depends on the location of the lesion and the size of the lesion and surrounding tissues removed. Returning to your normal activities may take 1 to 3 months after your surgery. Still, avoid any trauma to the brain and make sure to keep yourself from stress.
Take a lot of fruits and vegetables that will help aid your memory and quickly heal up the brain. Drink a lot of fluids especially water. Avoid smoking, alcohol, and a diet that contains caffeine.
SIDE EFFECTS & COMPLICATIONS OF LESIONECTOMY
The side effects and risk of lesionectomy depend on the the lesion’s location, its size, and the amount of tissue removed. The side effects may gradually go away as you recover, but the complications may be detrimental and will need to be attended to by the doctor. Side effects may include:
- With the predetermined location of the tumor, the area of the location on the brain is cut open through carefully traced incisions on the scalp, and the flesh is pulled aside.
- Any bone obstructing the area is removed from the skull.
- The tough membrane that shields the brain (dura) is pulled back from the area to expose the inside of the brain.
- Surgical microscopes are inserted through the window to give a magnified image of the lesion and surrounding tissues.
- Surgical probes with the aid of the microscopes are then inserted to remove the lesion and the surrounding damaged tissues.
- After that, the dura is pulled back in and the removed bone is replaced into the skull.
- Then, the scalp is pulled back and stitched.
The risks involved may include:
- Dizziness, tiredness, and depression.
- Loss of memory and difficulty in remembering.
- Personality changes
- Headaches that may come and go.
- Numb scalp
- Speaking difficulties.
- Finding it hard to articulate words.
- Distortion in sensory organs and paralysis.
There is an overall success rate of 84% with records of seizure-free living after the surgery. In a study, it is recorded that after 5 years of the surgery, the seizure-free rate was 57%.
- Allergic reaction to the anesthesia used.
- Bleeding in the brain.
- Infections that are likely to damage brain cells.
- Brain cells and tissue damage.
- Brain swelling.
- Seizures may continue.
· Neck pain or stiffness.
· Lack of appetite.
Brain lesions can be caused by injury, infection, exposure to certain chemicals, problems with the immune system, and more. Typically, their cause is unknown.
How effective is a lesionectomy in correcting seizures and epilepsy?
Lesionectomy has been found to have a high success rate in correcting any seizure or epileptic attack linked to a lesion in the brain. Once such a lesion is removed, the patient has a very high chance of being normal.
- What is the rate of a lesionectomy surgery recovery?
After surgery, you are advised to take 6 to 8 weeks before you can return to your normal activities such as work, school, etc. Get advice from your doctor about your recovery. Make sure to avoid stress and trauma to the brain within your recovery period.
- What is the difference between hemispherectomy and lesionectomy?
Lesionectomy is the removal of lesions from the brain, often done when the lesions cause seizures. However, hemispherectomy is the removal of one side (a hemisphere) of the cerebral cortex (the folded gray matter) of the brain. Hemispherectomy is done when seizures originate from several areas of a hemisphere.
- What is the difference between lesionectomy and lobectomy?
Lesionectomy removes lesions that cause seizures, whereas, lobectomy is the removal of a part of the entire temporal or frontal lobe in the brain that causes epileptic seizures.
- What is the survival rate of brain surgery?
Surviving a brain surgery depends on factors such as the location of the surgery, the type of the surgery, etc. However, generally, based on the 5-year survival rate, ages younger than 15 years, there is a 74% of surviving, ages 15 to 39 have a survival rate of about 70%, and ages 40 and above have a rate o of about 23%.