Cost of Lesionectomy Worldwide

A lesionectomy is a type of brain surgery performed to remove abnormal brain tissue (lesions) that are causing seizures or other neurological problems. These lesions may include tumours, vascular malformations, cortical dysplasia, scarring, or other abnormal brain structures. Lesionectomy is often used to treat drug-resistant epilepsy when seizures originate from a well-defined lesion identifiable on brain imaging. By removing the lesion, the surgery aims to reduce or eliminate seizures and preserve surrounding healthy brain tissue.

You should see a neurologist or neurosurgeon if you experience:

• Frequent or uncontrolled seizures, especially if medications are ineffective
• Neurological symptoms such as weakness, vision changes, speech difficulties, or memory problems
• Changes in personality or cognition
• Brain imaging (MRI, CT) that shows a lesion with unclear or suspicious features

Persistent neurological issues or structural brain abnormalities may indicate the need for further evaluation, possibly leading to surgical treatment like lesionectomy.

Preparation involves a comprehensive evaluation by a multidisciplinary epilepsy or neurology team:

• Neuroimaging: MRI, PET, or CT scans to locate the lesion
• EEG monitoring: To map seizure activity and confirm the lesion as the source
• Neuropsychological testing: To assess memory, language, and cognitive functions
• Functional MRI or brain mapping: To identify areas responsible for vital functions like speech or movement
• Medication review: Some drugs may be paused or adjusted before surgery
• Fasting: Usually required 6–8 hours before the procedure

Patients will meet with an anesthesiologist and surgeon to review risks, benefits, and expected outcomes.

• Anaesthesia: The patient is placed under general anaesthesia.
• Craniotomy: A portion of the skull is carefully opened to access the brain.
• Navigation and Mapping: Advanced imaging and intraoperative brain mapping guide the surgeon to locate the lesion precisely.
• Lesion Removal: The abnormal tissue is removed, taking care to avoid surrounding healthy or functional areas.
• Closure: The bone flap is replaced, and the scalp is sutured.

Depending on the lesion's location and the patient's condition, surgery may last 2 to 6 hours.

A lesionectomy usually takes 2 to 6 hours, depending on lesion size, location, and complexity. Patients typically stay in the hospital for 3 to 7 days for observation and early recovery.

Although lesionectomy is generally safe, potential risks include:

• Infection
• Bleeding
• Brain swelling
• Neurological deficits (speech, memory, or motor issues, depending on location)
• Seizures after surgery
• Cerebrospinal fluid leakage
• Anesthesia-related complications

These risks vary depending on the type, size, and location of the lesion in the brain.

• Seizure reduction or elimination, especially in drug-resistant epilepsy
• Improved quality of life, cognitive function, and independence
• Minimal disruption to the surrounding brain tissue when precisely targeted
• Increased effectiveness of medications post-surgery, if still required
• It can sometimes eliminate the need for lifelong anti-seizure medication

Lesionectomy is a valuable option when the abnormal area can be safely removed.

After surgery:

• Patients are initially monitored in the ICU and then transferred to a regular neurology unit.
• Headaches, fatigue, or confusion are common during early recovery.
• Physical, occupational, or speech therapy may be needed depending on outcomes.
• Most patients resume light activities in 2 to 4 weeks and return to work or school within 6 to 8 weeks.
• Follow-up includes neuroimaging, EEGs, and ongoing neurology consultations.

Patients must attend all post-operative visits and continue taking prescribed medications as advised.