What happens before brain tumour surgery

You usually go into hospital the day before, or on the day of your surgery.

You might have tests done when you arrive at the hospital. Or you may have already had them done in the outpatient clinic.

Before you go into hospital

It’s worth sorting out a few things before you go into hospital. These might include:

  • taking time off work
  • care for children or other loved ones
  • care for your pets
  • care for your house
  • cancelling your milk or newspapers

What to take with you

Take in:

  • nightgowns or pyjamas
  • underwear
  • dressing gown
  • slippers
  • contact lenses, solution, glasses and a case
  • wash bag with soap, a flannel or sponge, toothbrush and toothpaste etc
  • sanitary wear or tampons
  • towel
  • small amount of money
  • medicines you normally take
  • magazines, books, playing cards
  • headphones and music to listen to
  • a tablet or smartphone for web browsing, entertainment and phone calls
  • chargers for electronic devices
  • a copy of your last clinic letter

Time in hospital

Most people are in hospital for about 3 to 10 days. The length of your stay depends on the type of operation you have and your recovery. Everyone takes a different amount of time to recover from brain surgery.

Ask your doctors or clinical nurse specialist how long they think you will be in hospital for.

Family and friends

Before you go into hospital, it might be worth checking:

  • whether the ward is allowing visitors
  • if they have set visiting times
  • the best number for friends and family to phone, to find out how you are

The letter you receive before your operation may contain this information. But if not, you can phone the ward or hospital reception to find out.

You can use your mobile phone in hospital. But there may be some time before and after your operation when you won’t have your mobile nearby. And you may not feel like talking.

What happens on the day of surgery?

Your nurse will go through a series of questions on a checklist to make sure you are ready for surgery. They ask you to:

  • tell them when you last had something to eat and drink 
  • change into a hospital gown
  • put on a pair of surgical stockings
  • take off any jewellery (except for a wedding ring)
  • take off any make up, including nail varnish
  • remove contact lenses if you have them
  • put on 2 hospital identification bands, usually one on each wrist

If you have false teeth you can usually keep them in until you get to the anaesthetic room.

5-ALA (Gliolan)

5-ALA is also called 5-aminolevulinic acid or by its brand name Gliolan. It is a dye that makes some types of brain tumour cells glow under a fluorescent light. You might have it if you have a high grade (fast growing) glioma such as glioblastoma multiform (GBM).

5-ALA comes as a liquid that you drink 2 to 4 hours before surgery. The 5-ALA goes into your bloodstream and is taken up by the brain cells.

During the operation, your surgeon uses a fluorescent light and a microscope to look at the tumour. Under the fluorescent light, the brain tumour cells glow pink or red, while the healthy brain cells glow blue. This helps your surgeon to see the edges of the tumour more clearly so it’s easy to remove it.

5-ALA can cause some side effects. Side effects include:

  • low blood pressure
  • eyes and skin sensitivity to bright light
  • feeling sick

Your nurses check your blood pressure regularly before and after your operation. They ask you to avoid sunlight and bright light for about 24 hours after surgery.

Shaving your head before surgery

Not everyone needs to have their hair shaved before surgery. It depends on where the tumour is and the type of operation you have. Ask your surgeon what is going to happen in your situation.

If you do need to have your hair shaved, you might have part of your head shaved, or the whole head. This is usually done when you’re under anaesthetic in the operating room.

Do not shave your own head before you come to hospital for your operation. This could increase the risk of a wound infection.

You won't need to have your head shaved if you are going to have an operation to remove a pituitary tumour through the nose.

For tumours in the brainstem or back part of the brain (cerebellum), your surgeon might only need to shave a small area at the back of your head.

Having an anaesthetic

You have an anaesthetic so that you don’t feel anything during the operation. You have this in the anaesthetic room, next to the operating theatre.

All the doctors and nurses wear theatre gowns, hats and masks. This reduces your chance of getting an infection.

The anaesthetist puts a small tube into a vein in your arm (cannula). You have any fluids and medicines you need through the cannula including the general anaesthetic. This sends you into a deep sleep.

You might still have a general anaesthetic if you are going to have an awake craniotomy. If this is the case, you have a general anaesthetic at the start of the operation. The anaesthetic is then reduced so that you wake up for the main part. You then have another general anaesthetic for the last part of your operation. When you wake up again, the operation will be over.

When you wake up from surgery

After the operation, you usually wake up in the recovery room, the intensive care unit (ICU) or the high dependency unit (HDU).

  • Brain tumours (primary) and brain metastases in adults
    The National Institute for Health and Care Excellence (NICE), 2018

  • Cancer and its management (7th edition)
    J Tobias and D Hochhauser
    Wiley Blackwell, 2015

  • Cancer Principles and practice of oncology (8th edition)
    VT. De Vita, TS. Lawrence, and SA. Rosenberg
    Lippincott, Williams and Wilkins, 2008

  • The Royal Marsden Hospital Manual of Clinical Nursing Procedures (9th Edition)
    L Dougherty and S Lister
    Wiley-Black, 2015

  • Routine preoperative tests for elective surgery
    The National Institute for Health and Care Excellence (NICE), 2016

  • What is the surgical benefit of utilizing 5-ALA for fluorescence-guided surgery of malignant gliomas?
    C Hadjipanayis, G Widhalm and W Stummer
    Neurosurgery, 2015. Vol 77, Issue 5, Pages 663-673

Last reviewed: 
01 May 2019