Neurosurgery

January 12, 2026

This page was reviewed under our medical and editorial policy by Rosalind Munoz, P.A., Department of Medical Oncology & Therapeutics Research, City of Hope^® Cancer Center Duarte.

A patient with a tumor in the brain, spine or pituitary gland may need neurosurgery if the tumor is causing symptoms, pressing on important nerves or brain tissue or affecting how the body works.

What Is Neurosurgery?

Neurosurgery is a type of surgery that focuses on the brain, spine and nervous system. A physician who performs this kind of surgery is called a neurosurgeon.

Neurosurgeons operate on tumors in the brain, spine and pituitary gland — a small but vital gland at the base of the brain. These areas are closely linked because they’re all part of the central nervous system, which controls how the body moves, feels and functions.

Some tumors can grow in any of these places. For example, a tumor might start in the brain or in the pituitary gland or along the spinal cord. That’s why neurosurgeons are specially trained to work in these delicate areas — which share the same system of nerves and structures — to safely remove or treat tumors while protecting important brain and nerve functions.

Types of Surgery for Brain Tumors

Brain and spinal surgeries vary depending on the condition, tumor location and the safest way for the surgeon to reach it. In some cases, neurosurgeons use minimally invasive techniques to help patients recover faster.

Common types of brain, pituitary and spinal tumor surgery include:

Brain biopsy

If imaging tests indicate an abnormal growth in the brain, the care team may recommend a brain biopsy — removing a small piece of brain tissue, usually with a thin needle, to test for cancerous tumors and help guide treatment.

Craniotomy

Craniotomy is the preferred surgery for various brain issues, especially when treating a brain tumor.

With traditional craniotomy, the surgeon removes a small piece of skull to access the brain and then replaces it after surgery. This is used to treat tumors, relieve pressure or address other brain issues.

With awake craniotomy, part of the surgery involves brain mapping. By asking the patient to perform tasks, this technique allows the surgeon to remove tumors safely while protecting key areas for speech or movement.

Craniectomy

Similar to a craniotomy, a craniectomy surgery involves removing a piece of the skull to reach the brain. Unlike a craniotomy, the piece of bone isn’t put back right away because of swelling or pressure in the brain. Once the swelling has gone down, the surgeon performs a second surgery — called a cranioplasty — to replace the missing piece of skull and protect the brain.

MRI-guided laser ablation

Also called laser interstitial thermal therapy (LITT), this minimally invasive technique uses heat from a laser to destroy abnormal brain tissue. Guided by MRI scans, surgeons can target and treat tumors that are deep in the brain or difficult to reach with traditional surgery, such as glioblastoma.

Neuroendoscopy

During this minimally invasive approach, a surgeon uses a thin tube with a camera (endoscope) to access the brain through small openings in the brain or mouth. Neuroendoscopy is used to treat brain, spine and pituitary tumors.

The main types include:

• Endoscopic third ventriculostomy (ETV): Creates a small opening in the brain to help fluid flow and relieve pressure.
• Endoscopic tumor removal: Uses a camera to reach and remove tumors in the brain or spinal cord through a small opening.
• Endoscopic biopsy: Removes a small piece of tissue to check for disease without needing a large incision.
• Endoscopic cyst or abscess drainage: Drains fluid-filled cysts or abscesses to relieve pressure and symptoms.
• Transsphenoidal surgery: Removes pituitary tumors through the nose and sinuses, avoiding a large incision in the skull.

Shunt placement

Also known as brain shunt surgery, this procedure involves placing a thin, flexible tube in the brain to drain excess cerebrospinal fluid and relieve pressure.

Spine surgery

Neurosurgeons may operate on the spine to remove all or most of a tumor. This may help make subsequent treatments like radiation therapy or chemotherapy more effective.

Spine surgery may also be helpful when tumors press against nerves in the spine and cause issues with a patient’s central nervous system, such as paralysis.

Ommaya reservoir

Neurosurgeons may perform surgery to implant a device in the skull called an ommaya reservoir. Having this device in place may make it easier for the care team to deliver medications, such as chemotherapy, to the patient’s brain or spinal cord.

Skull base surgery

The surgeon may perform skull base surgery to address tumors or other disorders affecting the bottom of the skull. This area is challenging to access, so it may be performed using endoscopic tools and multiple surgeons.

After Brain Surgery

After brain surgery, the patient may stay in the hospital for a few days so the care team can continue to monitor him or her. Less invasive surgeries may only require 1–2 days, while open craniotomy recovery can take up to 10 days, often starting with a short stay in intensive care. To help gauge the success of treatment, the patient is likely to undergo an MRI or CT scan the day after surgery.

It’s common to receive medicine to help with tiredness, soreness or headaches. The patient may also need to keep taking certain medications to prevent complications.

To track recovery, the care team will order regular brain scans and follow-up appointments. Rehabilitation — such as physical, occupational or speech therapy — may help restore strength, mobility or speech affected by surgery.

Side Effects of Surgery

The side effects of brain surgery can vary depending on the tumor’s location, the type of surgery and the patient’s overall health. Some effects may last only a short period while the body heals, while others may last longer.

Short-term side effects (usually improve as the patient recovers):

• Headache or scalp pain
• Fatigue
• Brain swelling
• Temporary vision, hearing or speech changes
• Nausea or vomiting
• Dizziness
• Weakness or numbness in certain parts of the body
• Trouble with balance or coordination

Long-term side effects (may persist or be permanent):

• Difficulty with memory or focus
• Personality or mood changes
• Ongoing weakness, numbness or coordination problems
• Persistent speech or vision issues
• Seizures
• Hormone changes if the pituitary gland or nearby areas were impacted

The care team will monitor the patient closely after surgery and work with rehabilitation specialists — such as physical and occupational therapists and speech-language pathologists — to help the patient regain as much function as possible.