Surgery has a fundamental role in the management of brain tumors from a diagnostic point of view (to make an accurate histopathological diagnosis) and from a therapeutic point of view (tumor resection).
The main goal of the surgery is to achieve a complete tumor resection without leaving neurological deficits.
Intracranial tumors can be treated surgically through a craniotomy. Surgery may be curative in some tumors like grade I meningiomas, adenomas, pinealomas and some benign gliomas in the case of achieving a complete tumor resection.
In the case of malignant tumors such as some gliomas, brain metastases, medulloblastomas and malignant tumors of the pineal region, surgery is also essential. Their complete resection improves survival and reduces the risk of recurrence. Moreover, surgical resection decreases the risk of malignant transformation in diffuse low-grade gliomas.
Neuronavigation may be helpful in improving the percentage of complete resections and minimizing the surgical approach to the tumor using minimally invasive surgery (see surgical techniques section).
Depending on the location of the tumor and with the aim of avoiding the occurrence of neurological deficits, it is sometimes necessary to use brain mapping or intraoperative neurophysiological monitoring techniques (see surgical techniques section).
If the surgical resection of the tumor is not possible it is necessary to perform a neuronavigated brain biopsy or a stereotactic biopsy (see surgical techniques section) in order to make an accurate diagnosis. After that, the appropriate oncological treatment can be administered (chemotherapy, radiotherapy, or a combination of both).