Microsurgery for the Brain

UPMC commits to finding the best treatment approach for you, reducing your risks, and improving your surgical outcome. With a primary focus on neurological microsurgery, we represent one of the largest and most experienced centers in the world.

How Micro Neurosurgery Works

Neurosurgeons use microsurgery to treat brain and spine conditions. These procedures are also known as micro neurosurgery. High-powered operating microscopes, considered the standard for safe and precise neurosurgery in critical areas, are the key to these surgeries. Many of these procedures are minimally invasive, which means surgeons don't need to make large incisions.

UPMC neurosurgeons minimize incisions and insert microsurgical tools to repair damage. They use operating microscopes to see in detail:

• The blood vessels
• Brain tissue
• Spine and spinal cord.
• Nerves

With powerful operating microscopes, neurosurgeons can see small areas of the brain and spine. Many of these microscopes also have robotic features, allowing greater precision and efficiency in the operating room.

UPMC neurology and neurosurgery experts use microsurgery for many conditions. Our surgeons:

• Remove tumors located near blood vessels or nerves.
• Treat blood vessel problems like aneurysms and arterial malformations.
• Carefully decompress the spinal cord or nerves by removing herniated disks or repairing degenerated joints in the spine.

Using these techniques, surgeons can treat nerve compressions in the brain as well as remove tumors at the base of the skull.

Microsurgery Treatments

We offer microsurgical treatments that include:

• Aneurysm clipping — Making a small opening in the skull and placing a small metal clip on the aneurysm's neck to stop its blood supply.
• Arteriovenous malformation (AVM) resection — Cutting off the blood supply to the AVM and delicately removing it from the surrounding tissue.
• Awake craniotomy — Monitoring critical brain functions, such as speech and movement, to safely remove tumors during traditional neurological surgery.
• Brain and skull base tumor resection — Removing a tumor through traditional, microsurgical methods when minimally invasive procedures are not an option. Many minimally invasive techniques also use microsurgery, especially transorbital approaches.
• Carotid endarterectomy — Making a small incision in the neck and removing plaque blocking the carotid artery.
• Microvascular Decompression —Making a small incision behind the ear followed by a craniectomy (bony opening) the size of a silver dollar. This leaves a nonstick PTFE (polytetrafluoroethylene) "pillow" in between the blood vessel and affected nerve.
• Lumbar and cervical discectomy — Removing the ruptured disc and any fragments using a one-inch incision and microsurgical tools in the midline of the lower back.
• Posterior fossa decompression — This involves removing a small section of bone from the back of the skull and adding a patch to increase space and reduce pressure.

Conditions Treated With Micro Neurosurgery

UPMC experts treat all brain and spine conditions. We use microsurgery to treat:

• Arteriovenous malformations (AVM): Tangled arteries and veins in the brain or spinal cord that interfere with blood flow.
• Brain abscess: Tissue that grows around an infected area of the brain.
• Brain aneurysm: Bulging or ballooning in a brain artery wall.
• Brain hematoma: Blood that has pooled within a specific area of the brain.
• Brain hemorrhage: The breaking of a blood vessel that causes bleeding in the brain.
• Brain and skull base tumors: Mass that forms when brain cells grow in abnormal ways.
• Seizures: Episodes that disrupt the brain's electrical signals.
• Spinal tumors: Cells that grow in unusual ways, forming a mass in or around the spinal cord.
• Spine degeneration: Loss of normal structure and function of the spine, often caused by herniated discs and joint arthritis.

What To Expect From Micro Neurosurgery

Your surgeon will recommend the best microsurgery procedure for your specific condition. Talk to your doctor about:

• Whether you should stop taking medications or supplements before the procedure.
• How long you should expect to stay in the hospital.
• Whether you'll need someone to help you at home after the surgery.
• How to manage any discomfort you may feel afterward.

Depending on the procedure, you may stay in the hospital for a couple of days. You may have:

Awake microsurgery

You receive medication so you won't feel pain (known as local anesthesia) and mild sedation during certain parts of surgery. You can talk with your surgeon during this and follow certain commands. Using awake microsurgery, surgeons can treat seizures, tumors that affect speech and movement without harming these functions.

General anesthesia for microsurgery

Doctors give you medication that puts you to sleep (general anesthesia) during microsurgery. You won't feel any pain or remember anything. Surgeons may use general anesthesia during procedures that need a lot of precision, so you stay completely still.

What to expect from recovery

Immediately afterward, you'll move to a recovery area. Specialists observe you as anesthesia wears off to make sure your blood pressure, breathing, and heart rate return to normal. When you've awoken and your vital signs are stable, you'll move to a regular hospital room to continue your recovery.

Your doctor will talk with you about what to expect while you recover. They tell you about:

• Any side effects or new symptoms.
• How to take care of your healing incisions.
• Any new medications you might need and how to take them.
• Other therapies — such as physical therapy or speech and swallowing therapy — you might need.

Our Expertise

UPMC neurology and neurosurgery specialists are experts in diagnosing all conditions of the brain and spinal cord. We treat these conditions with minimally invasive microsurgery procedures whenever possible. Our neurosurgery team has a long history of leading the way in developing new microsurgery techniques.

Our experts lead and take part in studies and clinical research of new minimally invasive brain surgeries. We're always looking for the most promising new neurosurgical treatments. At UPMC, we talk with you about the microsurgery treatment that's right for you.