On the day of your 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.

What happens on the day?

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.

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).