Our Services / Brain Surgery

When would I need brain surgery?

Dr. Mesiwala performs emergency brain surgery for life-threatening conditions such as an aneurysm, subdural hematoma, or hemorrhagic stroke. In all other cases, he first reviews your medical history, does a physical exam, and completes extensive neurological evaluations and diagnostic imaging.

Then he talks with you about your condition and all of the possible treatment options. After answering your questions, he works together with you to decide if brain surgery is the best option.

What conditions may need brain surgery?

Dr. Mesiwala has extensive experience performing brain surgery for many conditions, including:

• Hydrocephalus
• Cerebral aneurysm
• Arteriovenous malformation
• Traumatic brain injuries
• Chiari malformation
• Cranial nerve disorders
• Movement disorders
• Hemorrhagic stroke
• Subdural hematoma
• Trigeminal neuralgia

Dr. Mesiwala also performs surgery to remove brain tumors.

What type of brain tumor might need surgery?

Brain tumors are classified as primary (originating in the brain) or metastatic (beginning elsewhere in the body and traveling to the brain). Primary brain tumors may be malignant or benign, while secondary tumors are always cancerous.

Dr. Mesiwala treats all types of brain tumors. A few examples include:

• Meningiomas
• Astrocytomas
• Glioblastoma
• Schwannomas
• Acoustic neuroma
• Pituitary tumor (Pituitary Adenoma) 
• Gliomas
• Skull base tumors

Some benign tumors pose a serious threat; they rapidly grow and invade the surrounding areas of your brain.

What symptoms indicate I need brain surgery?

The symptoms you experience depend on the condition. If you have a tumor, factors include its location and size. However, the most common symptoms include:

• Headaches
• Seizures
• Fatigue
• Mood swings
• Vision loss
• Double vision
• Sensitivity to light
• Memory loss or confusion
• Nausea and vomiting
• Difficulty swallowing
• Numbness or weakness on one side of your body

Frequent or severe headaches are one of the earliest symptoms of a brain condition.

What type of brain surgery might I need?

These are a few of the most common types of brain surgery performed by Dr. Mesiwala: 

Craniotomy

During a craniotomy, Dr. Mesiwala temporarily removes a piece of your skull to access your brain. He may recommend a craniotomy when he needs to remove a tumor or to treat a cerebral aneurysm, arteriovenous malformation, or trigeminal neuralgia, to give you a few examples. 

Cranioplasty

Cranioplasty is a procedure to correct a defect in the skull. The procedure may include reshaping or repositioning the skull, implanting hardware, or replacing the bone. 

Suboccipital craniectomy and laminectomy or duraplasty

This surgery targets the base of the skull, where Dr. Mesiwala may decompress the first cervical vertebrae (laminectomy) or repair the brain's outer cover (duraplasty). 

Gamma Knife® stereotactic radiosurgery

This procedure doesn't rely on an incision. Instead, it treats brain tumors using hundreds of radiation beams. The procedure treats the entire tumor from all sides by sending radiation beams from all directions.

Each individual beam has a low intensity, so it doesn't harm your skin or the surrounding brain structures. But when hundreds of beams converge on the tumor, their combined effect creates a high dose of radiation that kills the cells. 

Endoscopic surgery

Endoscopic surgery, a minimally invasive procedure, uses a narrow instrument that contains lighting and a video camera. After inserting the scope, Dr. Mesiwala receives high-definition images on a monitor, then he guides instruments through the scope to perform your surgery. 

If you need surgery at the front of your brain or the top of your spine, Dr. Mesiwala can guide the scope through your nose. He often recommends endoscopic surgery for skull base tumors, which require exceptional skill to remove. 

Cerebrospinal fluid (CSF) shunt

If you have too much CSF around your brain due to hydrocephalus or pseudotumor cerebri (idiopathic intracranial hypertension), the excess fluid places too much pressure on your brain. Dr. Mesiwala implants a shunt to drain the fluid. 

If you have worrisome symptoms or questions about brain surgery, don't wait to see Ali H. Mesiwala, MD, FAANS. Call the nearest office or book an appointment online today.