Tag Archives: Modern Management of Brain Tumors

Advanced Brain Surgery Techniques Improve Outcomes

By Jonathan A. Engh, MD
Lexington Medical Center Brain Tumor Program

Brain surgery is essential, and even life-saving, to the care of many patients with brain tumors or other brain conditions. However, it is not without substantial risk. One of the central principles of medicine is “primum non nocere,” or “first do no harm.” It’s a reminder that our interventions for disease may cause injury to a patient, and that we must avoid injury whenever possible.

Few interventions in medicine are more potentially dangerous than brain surgery. Stroke, hemorrhage and infection are just a few of the potentially devastating complications that can harm a patient or even lead to death. At Lexington Medical Center, we utilize on specialized techniques, not widely used at most medical centers, to reduce the risk of brain injury from tumor surgery.

Awake craniotomy is a specialized method of brain tumor surgery in which the patient remains awake and alert during surgery. While being kept comfortable, the patient can talk, move an extremity of interest, or name objects on a screen. This allows the neurosurgeon to track patient’s motor function and speech in real time during the operation.

It is critical that the entire operating room team be specially trained in this technique in order for it to be successful. Otherwise, the patient can be more prone to problems like breathing complications or seizures in the operating room. Lexington Medical Center has a dedicated team that specializes in awake craniotomy for brain tumors. Using this technique allows us to work in functional regions of the brain while keeping track of the patient’s neurologic state. As a result, we can remove brain tumors that would otherwise not be safely removable.

Minimally invasive port surgery is another specialized technique utilized to prevent injury in the operating room at Lexington Medical Center. Using a small, cylinder-shaped retractor, the neurosurgeon can access deep brain regions with less disruption to the surrounding brain tissue. With this technique, patients with deep brain tumors and tumors in the fluid system of the brain (intraventricular tumors) can have successful surgery and achieve relief of their symptoms while minimizing the risk of being injured during their operation.

To learn more about the Lexington Medical Center Brain Tumor Program, visit www.lexingtonbraintumor.com.

Modern Management of Brain Tumors

Dr. Johnathan Engh is a neurosurgical oncologist at Lexington Brain and Spine Institute, a Lexington Medical Center physician practice. He specializes in tumors of the brain and spine. He talked about the latest treatment measures in this WLTX interview.

There are several types of brain tumors, typically divided between primary and metastatic brain tumors. A primary brain tumor grows from the brain itself; a metastatic brain tumor has spread to the brain from another part of the body. Some are malignant, others are benign. Brain surgeries can be complex.

According to Dr. Engh, brain tumors tend to present with headaches, confusion, an unexplained seizure as well as speech, memory and vision problems. Keep in mind the vast majority of headaches are not brain tumors.

Dr. Engh specializes in the most innovative ways to treat brain tumors. That includes minimally-invasive port surgery, a procedure that allows a surgeon to treat deep-seeded tumors while minimizing trauma to surrounding brain tissue.

Awake craniotomy, another innovative technique, maps the brain and allows the patient to participate in the surgery. If the patient is awake for a portion of the procedure, a doctor can ensure that speech and other neurological function is OK while the surgeon works on the tumor. There’s no machine that can do that. Awake brain surgery can maximize a patient’s outcome.

Finally, radiosurgery is a precise application of radiation without an incision and given on an outpatient basis. It can be very effective in shrinking tumors and preventing someone from needing surgery.

Dr. Engh’s expertise helps to allow people in the Midlands to receive world-class cancer care that’s close to home.