As neurosurgeons part of our work is treatment of brain tumours. These can be either cancerous (malignant) or non-cancerous (benign). These are commonly treated in the multidisciplinary setting of the Edinburgh Centre for Neuro-oncology, at the Western General Hospital, Edinburgh.
Benign tumours as for example meningiomas can be often followed by regular imaging and surgical treatment can be delayed.
Some tumours can be malignant but with minimal activity and these are called low grade tumours. When surgery required, it is often done using awake surgery or supporting neurophysiology monitoring and other specialist equipment. Mr. Imran Liaquat is leading treatment of low grade glioma tumours in Western General Hospital.
Some tumours can be found in spaces inside the brain called ventricles. Ventricles are filled with spinal fluid and can often be accessed using endoscope for variety of treatments.
It is one of the most complex and beautiful surgical subspecialty and requires huge amount of resources and involvement of many specialists. Epilepsy surgery in the modern era has been repeatedly shown to be safe and effective. It is reserved for people who keep having uncontrolled seizures despite multiple medications. Drug resistance has recently been defined by the International League Against Epilepsy (ILAE) as a “failure of adequate trials of 2 tolerated, appropriately chosen and used antiepileptic drug schedules (whether as monotherapy or in combination) to achieve sustained seizure freedom. It is not necessary to have frequent seizures to be considered for surgery if they significantly interfere with patient’s life. Unfortunately epilepsy surgery is still underused and many adults are referred for surgery consideration after many years of seizures. Chronic seizures increase risk of death, interrupt social interactions, interfere with employment and others. Early consideration for surgery is especially important in children as to avoid prolonged drug use and toxicity, improve child development and use recovery potential of young growing brain.