Surgery is often the first treatment for brain tumors, according to the National Cancer Institute. To access the brain tumor, the surgeon must perform a craniotomy, removing a part of the patient’s skull. The patient is given anesthesia during the operation and the surgeon replaces the part of the skull that was removed.
If the patient undergoes a craniectomy, the bone is not replaced after closing the incision, which can occur in cases in which swelling is expected. In some cases, the patient may be awake during surgery.
This is called an awake craniotomy, in which the patient is under local anesthesia. With this type of craniotomy, the surgeon can ask the patient to follow certain commands, which helps prevent damage to critical areas of the brain. Once the surgeon has access to the brain, she can begin removing the tumor. Options include debulking, partial removal and complete removal.