Brain surgery in Tijuana

What brain surgery is, and when it is indicated

Brain surgery covers the procedures that treat lesions inside the skull: tumours, blood collections, vascular malformations, infections and the consequences of head trauma. They share an access route — usually the craniotomy — but very little else: each indication has its own work-up, technique and prognosis.

A surgical indication arises when three things agree: the patient's symptoms, the neurological examination and what the imaging shows. When those three point to the same place, there is a surgical case. When they do not, the prudent course is more investigation, not earlier surgery.

The commonest conditions

The pictures that most often reach this office are brain tumours — gliomas, meningiomas, metastases and pituitary adenomas — head trauma with intracranial haematomas, intracranial aneurysms and subarachnoid haemorrhage, hydrocephalus in children and adults, and ischaemic stroke with mass effect.

Also treated are trigeminal neuralgia, hemifacial spasm, facial palsy, epilepsy with a structural lesion, arachnoid cyst, brain abscess and congenital malformations of the nervous system. Each has its own page in the conditions section.

How an intracranial lesion is investigated

Contrast-enhanced MRI is the reference study: it defines margins, oedema, the relationship to eloquent areas and structural shift. CT is faster and is what emergency departments use, and what shows bone and acute bleeding, but it does not replace MRI.

Where vascular pathology is suspected, CT angiography or cerebral angiography is added. And for lesions near language or motor cortex, planning includes choosing the approach corridor that crosses the least healthy tissue. Surgery starts on the screen, not on the skin.

What happens in theatre, and what is protected

The approach is chosen as a corridor: pterional, subtemporal, retrosigmoid, orbitozygomatic or transsphenoidal, according to where the lesion sits and what lies on the way. The operating microscope, the ultrasonic aspirator and fine bipolar coagulation allow work in a plane of millimetres.

The limit of resection is set by function, not by ambition. When removing the last millimetre of tumour would cost speech, the strength of a hand or vision, a safe resection plus follow-up or radiosurgery is preferred. That decision is discussed beforehand, not improvised inside.