Why is stereotactic ablation done?
You may need this surgery if you have a movement disorder (for example, essential tremor, familial tremor or Parkinson’s disease) or if you have epilepsy and suffer medically refractory seizures or certain types of brain tumors that may not be able to be treated with standard open brain surgery. The goal of these surgeries it to create a lesion in the brain with energy in the form of heat (electrical, laser, radio wave or ultrasound). Every ablation procedure has the same goal, but the technology used to create the lesion is different.
For movement disorder procedures, deep brain stimulator surgery has been well-established for over 30 years and is typically recommended over stereotactic ablation therapy. For other indications, stereotactic ablation therapy can be an option when formal open surgery is not. You should ask your doctor about your specific condition and whether these surgeries are right for you.
How is stereotactic ablation done?
The surgery can be done with or without a frame, which is a device that is fixed onto your head before getting an MRI of your brain. This defines the “frame based stereotactic” surgery versus the “frameless stereotactic” surgery. Regardless of the frame, a special high-resolution MRI will be done before your surgery to help target the exact part of your brain that needs to be treated.
You will be brought into the operating room and typically given conscious sedation with medications given through your IV to make you feel comfortable without going to sleep completely. During the procedure, you may be asked to give feedback about what you are feeling.
For epilepsy surgery and surgery for brain tumors, it is not common for the neurosurgeon to get your feedback, so you will be able to go to sleep completely for the procedure.
After the procedure, you will typically spend one night in the hospital and likely go home the next day. You should ask your doctor about your specific surgery.
What are my risks? What are common complications?
With any surgery there are risks. You should talk to your doctor about them. Some common complications include brain injury to the structures right next to where the lesioning needs to occur, bleeding and risks from anesthesia. Anytime you undergo full anesthesia, there is a risk of stroke or neurological injury. These risks are typically lower than with formal open brain surgery and will be discussed with your doctor.
What do I need to know before surgery?
Any type of brain surgery is a stressful event for you and your family. Your surgical team is very experienced and will provide excellent care. You will be asked to answer a lot of questions and will have other tests done before surgery. You should follow all instructions given to you before surgery. The amount of time you will spend in the hospital after a surgery should be short; most patients require only a one-night stay. It is very important that you do not take any blood thinning medication for one week before your surgery. This includes any vitamins, herbs or supplements that may have blood thinning components in them.
General discharge instructions
Your healthcare provider will give you specific instructions when leaving the hospital. In general, shower daily and keep your incisions clean with soap and water, but do not immerse/soak your incisions under water. (Do not take a bath or swim.) Do not touch, manipulate or scratch your incisions. Avoid straining or lifting heavy objects. Eat a well-balanced diet to help with healing. Make sure someone looks at your incisions every day and contacts your doctor’s office with any concerns. Most patients can resume normal activity a few weeks after surgery. Almost all patients having this type of surgery recover faster than with a formal open brain surgery.
What should I expect while recovering?
You may be sore at your incision site(s). This is temporary and will get better over time. You may feel more tired when first returning home. Be sure to rest; however, you should try to walk daily and increase this as you start to feel better.
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