Craniotomy & Brain Tumour Resection

Craniotomy with brain tumour resection is a neurosurgical procedure to remove or debulk tumours of the brain, whether primary (arising from brain tissue) or secondary (metastatic from cancers elsewhere in the body). At SilverOak Health, our neurosurgical team employs the full range of modern surgical technology — including neuronavigation, intraoperative MRI, fluorescence-guided surgery, and awake craniotomy — to maximise the extent of safe tumour resection while preserving neurological function.

Pre-operative planning involves detailed review of multiparametric MRI — including diffusion tensor imaging (DTI) for tractography of eloquent white matter tracts — to map the relationship between tumour and critical functional areas including motor, speech, and visual cortex. Intraoperative navigation using pre-operative MRI data guides the surgical approach in real time, while 5-ALA fluorescence highlights tumour tissue with pink fluorescence under blue light, enabling surgeons to identify and remove tumour tissue that appears normal under white light.

Awake craniotomy — in which the patient is maintained awake during the resection phase while the neurosurgeon performs continuous neurological testing — is offered for tumours involving or adjacent to eloquent cortex. Direct cortical and subcortical stimulation mapping identifies functional boundaries that must be respected during resection, dramatically reducing the risk of permanent neurological deficit. Post-operative care in our neurosurgical intensive care unit includes neurological monitoring, ICP management if required, and early involvement of our neurorehabilitation team. Our brain tumour MDT meets weekly to plan adjuvant treatment and coordinate ongoing oncological management.