How does neurosurgery work? How does the surgeon identify which parts of the brain are okay to cut and which one’s arent’t? Isn’t everyone’s brain structured differently?

Question

With other surgeries I guess it’s possible for the surgeon to identify the different tissues, nerves, and blood vessels through an X-ray or CT scan and plan the surgery accordingly

But with the brain, doesn’t everything look like a big blob of brain tissue? How can the surgeon tell what part of the brain performs what function and what’s safe to cut so that he can access the tumor? How would he avoid a Phineas Gage type outcome?

In: 33

Answer 1

For some surgeries, patients will need to be awake during the surgery.

If they’re going in to fix a bleed, or take out something, they just get in and out where they need to and that’s that. They use imaging to know where to look and what’s going on before going in.

I saw a surgery on tv (surgery channel or whatever it was) where a person had seizures and so they had to be awake for the surgery. The dr would stimulate a part of the brain with a tiny electric lead, and ask questions or have the patient talk, and if that part effected the patients talking or responses, they knew that was the problem area and cut it out.

It was fascinating.