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Craniotomy for childhood brain tumours

A neurosurgeon may perform a craniotomy for brain tumours in children to remove as much of the tumour as is safely possible

When possible, the neurosurgeon will try to remove all of the tumour, or as much of your child's tumour as is safe to. During surgery a 'bone flap' will be removed from your child's skull. This type of operation is known as a 'craniotomy'. It allows the neurosurgeon to see into your child's brain and to remove the tumour.

It is the most common type of surgery for brain tumour patients and it is used to remove all or part of the tumour.

You may hear the complete removal of the tumour being called 'total resection'. Or removal of part of the tumour as 'partial resection' or 'de-bulking'.

The aims of removing the tumour include:

  • increasing the chances of a cure
  • slowing the tumour's growth
  • improving symptoms e.g. to reduce pressure on vital nerves within the brain, such as the optic nerve
  • helping other treatments to work better, such as chemotherapy or radiotherapy

Craniotomy procedure

  1. Your child will be given a general anaesthetic to fall asleep
  2. A small area of their head may be shaved and they may be given an local anaesthetic to part of their scalp
  3. An incision (cut) is made in their scalp and a small part of their skull ('bone flap') will be removed
    Your child will not experience any pain during this as they will be under anaesthetic
  4. As much of the tumour as is safely possible will be removed
  5. The bone flap will be replaced and the wound closed using stitches or metal clip
  6. They are likely to be given steroids to help with any swelling

Not all brain tumours can be operated on. If the tumour is too near a sensitve area of the brain, such as the brain stem which controls breathing; or if it is slow growing and causing relatively minor symptoms, then trying to remove the tumour is likely to cause more harm than not operating. If this is the case, your child will be actively monitored. (This is sometimes called 'watch and wait'.)

Why might the surgeons not operate to remove my child's brain tumour?

Surgeons may not operate if:

  • the tumour is in, or near, a sensitive area of the brain and operation is likely to cause damage to this area. E.g. the brain steam (which controls breathing), or the optic nerve (responsible for sight)
  • the tumour is low grade (slow growing, unlikely to spread and causing relatively minor or controllable symptoms)
  • the risk of a major operation to remove the tumour is more likely to cuase harm to the brain than not doing anything. This is called 'watch and wait'.
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