Preparing for Brain Surgery
Find out about what happens before surgery, the people you’ll meet and the exercises you need to do.
Tests to check you are fit for surgery
You have tests before your operation to check:
- your fitness for an anaesthetic, if you need one
- that you’ll make a good recovery from surgery
You might not need all of these tests if you had them when you were diagnosed. Tests include:
- blood tests to check your general health and how well your kidneys are working
- an ECG to check that your heart is healthy
- breathing tests (called lung function tests)
- an echocardiogram (a painless test of your heart using sound waves)
- a chest x-ray to check that your lungs are healthy
You might also have an ECG while you are exercising.
Depending on the type of brain tumour you have, you might also have some of the following tests.
Blood tests to check for hormone levels or chemical markers
You might have blood taken to measure hormone levels for pituitary tumours. Or a test to check for chemical markers for pineal region tumours and some pituitary tumours. Markers are chemicals that are produced by certain types of tumour and can be picked up in the blood. They might also be used to monitor the effect of the treatment and to pick up signs of the cancer coming back.
An electroencephalogram (EEG)
An electroencephalogram (EEG) is an electrical reading of your brain wave patterns. You might need to have this if you have fits (seizures) as a symptom of your brain tumour. It is completely painless.
You have about 20 pads attached to your head with gel, sticky tape, or by putting on a rubber cap. The pads are attached by wires to the EEG machine. The technician then asks you to lie down and relax. It usually lasts an hour or less.
The EEG machine produces a print out of your brain waves and the your specialist will check for any abnormal changes.
You might have neuropsychology tests if your tumour is affecting your thought patterns or memory. Your doctor or a psychologist will ask you a wide range of questions about different subjects. The tests can give a baseline of how you are. Your treatment team can compare the results to the same tests done again after your treatment.
An angiogram looks at blood vessels and blood flow under x-ray.
Angiograms are sometimes done before surgery if your tumour is near or around a blood vessel inside the brain. It helps the surgeon to plan the operation and avoid damage to the blood vessel if at all possible.
You have frequent neurological observations (neuro obs) during your hospital stay. You have these before your operation to give a baseline. Then at regular points after your operation. They include:
- asking you questions to see how alert you are
- asking you to squeeze the nurse’s hand or push your foot against it
- shining a light into your eyes to check that your pupils react
- taking your pulse, temperature, blood pressure and breathing rate
For example, you may have weakness in one hand before the operation. By checking and recording this, your nurses and doctor will know if it has got worse or better after your treatment. You might hear your doctor or nurse talk about your GCS score. This stands for Glasgow Coma Scale and is the form they use to record your neuro obs.
Pre assessment clinic
A week or 2 before your surgery you have an appointment at the hospital pre assessment clinic.
Your pre assessment appointment prepares you for your operation.
You meet members of your treatment team at this appointment and you can sign the consent form to agree to the operation.
Ask lots of questions. It helps to write down all your questions beforehand to take with you. The more you know about what is going to happen, the less frightening it will seem.
You can ask more questions when you go into hospital so don’t worry if you forget to ask some. At the hospital you might meet:
A member of the surgical team will tell you about:
- the operation you are going to have
- the benefits of having surgery
- the possible risks
- what to expect afterwards
The anaesthetist gives you the anaesthetic and looks after you during the operation. They make sure you’re fit enough for the surgery.
The nurse checks your:
- general health
- blood pressure
The nurse also checks what help and support you have to see what you will need when you go home. They are your point of contact and care for you throughout your treatment.
The dietitian gives you help and advice about managing your diet. They:
- help you get as well as possible before your operation
- explain how the surgery affects your diet
- give useful tips on how to increase your nutrients and calories
They might give you nutritional supplement drinks to have before surgery.
Some people need a feeding tube in their stomach or small bowel. This makes sure you get the nutrition you need before your surgery.
The physiotherapist assesses how well you can move around. They let the doctors know if there is anything that could affect your recovery.
The physios also teach you leg and breathing exercises to do after your operation to help with recovery. Learning how to do the exercises beforehand makes it easier afterwards.
Learning breathing and leg exercises
Breathing exercises help to stop you from getting a chest infection. If you smoke, it helps if you can stop at least a few weeks before your operation.
Leg exercises help to stop clots forming in your legs. You might also have medicines to stop the blood from clotting. You have them as small injections just under the skin. They are heparin, tinzaparin or dalteparin.
You start the injections just before your operation. You might also wear compression stockings.
This 3-minute video shows you how to do the breathing and leg exercises.
Medicine you might need to take
You might need to start steroids and possibly drugs to stop fits (seizures) a few days before your surgery. Check with your surgeon or specialist nurse if you are not already taking them.
An operation can make the brain tissue swell up more. This can increase the pressure in your skull and so make your symptoms worse for a short time. Steroids help to reduce swelling and pressure around the brain.
Once you have recovered from your operation, your surgeon will tell you to slowly reduce the dose, then stop the steroids. There is no fixed treatment time for steroids. It varies from person to person.
Bring all your medicines along to the hospital with you.
It is natural to be anxious about having brain surgery. It can be a frightening thing to think about. But brain surgeons are very skilled and it is a specialist area.
Do talk about any worries with your family and friends if you can. They are probably thinking the same things as you. Together you can talk things through and make a list of questions to ask your doctor.
You can share your concerns with your nurses too. They will be able to tell you what will happen and how it is likely to affect you. You may find that the more you know about your operation and the likely recovery, the less frightening it will seem.