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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 (swellings filled with blood). It is appropriate only for partial seizures.
Fig : Lesionectomy
This procedure is done under general anesthesia.
A lesionectomy requires exposing an area of the brain using a procedure called a craniotomy.
An incision (cut) is made on the scalp,surgeon removes a piece of bone and pulls back a section of the dura, the tough membrane that covers the brain. This creates a "window" in which the surgeon inserts special instruments for removing the brain tissue.
Surgical microscopes are used to give the surgeon a magnified view of the lesion and surrounding brain tissue. The surgeon utilizes information gathered during pre-surgical brain imaging to help identify abnormal brain tissue and avoid areas of the brain responsible for vital functions.
In some cases, a portion of the surgery is performed while the patient is awake, using medication to keep the person relaxed and pain-free. This is done so that the patient can help the surgeon find and avoid vital areas of the brain.
While the patient is awake, the doctor uses special probes to stimulate different areas of the brain. At the same time, the patient is asked to count, identify pictures or perform other tasks. The surgeon can then identify the area of the brain associated with each task.
After the brain tissue is removed, the dura and bone are fixed back into place, and the scalp is closed using stitches or staples. Most people who have a lesionectomy will be able to return to their normal activities, including work or school, in 6 to 8 weeks after surgery
This local surgery, which can cure the patient's epilepsy, has become possible with the advent of advanced imaging techniques such as MRI.
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