What Is a Lesionectomy ?

A lesionectomy is an operation to remove a lesion — a damaged or abnormally functioning area — in the brain. Brain lesions include tumors (masses of cells), scars from a head injury or infection, abnormal blood vessels and hematomas (swellings filled with blood).

A lesion causes seizures (is the seizure focus) in about 20% to 30% of people with epilepsy that do not improve after taking medication (intractable or refractory epilepsy). It is not known for certain if the lesion itself triggers the seizures, or if the seizures result from irritation to the brain tissue surrounding the lesion. For this reason, surgery may also include the removal of a small rim of brain tissue around the lesion, called lesionectomy plus corticectomy.

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Who Can Have a Lesionectomy ?

Surgeons generally only perform lesionectomies on people who have abnormal lesions on the brain that are the identified source of seizures.

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Lesionectomy may be an epilepsy surgery option for those who : -

  • Have seizures that are localized to that lesion and that area of the brain
  • Have lesions in an area of the brain that can be easily removed with little or no damage to brain function
  • Have seizures that can’t be managed with epilepsy medications, which have been tried for at least two years prior to considering surgery
  • Have lesions that need to be removed anyway, to prevent further complications such as bleeding or growth of a tumor

What Happens During Surgery ?

A lesionectomy requires exposing an area of the brain using a procedure called a craniotomy. After the patient is put to sleep, the surgeon makes an incision in the scalp, removes a piece of bone and pulls back a section of the dura, the tough membrane that covers the brain. This creates a “window” in which the surgeon inserts special instruments for removing the brain tissue. Surgical microscopes are used to give the surgeon a magnified view of the lesion and surrounding brain tissue. The surgeon utilizes information gathered during pre-surgical brain imaging to help identify abnormal brain tissue and avoid areas of the brain responsible for vital functions.

Lesionectomy Success Rates in India

Along with low risks, lesionectomy also offers great success rates in effectively controlling seizures. Success rates do vary, however, based on where in the brain the lesion is located.

Lesionectomy for lesions in the temporal lobe offer the best results, showing significant improvement in more than 80 percent of people who have this surgery. Many of those people don’t have any more seizures following lesionectomy.

How much of the lesion is removed is another factor in determining how successful the surgery is. The more of the lesion that’s removed, the better – people who only have a portion of a lesion removed do not see as great a benefit in seizure reduction as those who lose the entire lesion.

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