A lesionectomy is a surgery during which lesions are removed from the brain. They include scars for a head injury or infection, abnormal blood vessels, hematomas, and tumors.
Lesion causes seizures in some people with epilepsy which cannot be improved with medications. In this situation, the removal of a small rim of the brain tissue around the lesion is also necessary (surgery called corticectomy).
Before surgery, preoperative evaluations will be done including electroencephalography (EEG) and magnetic resonance imaging (MRI) to help locate the lesion and to confirm that the lesions are the source of the seizure.
During the procedure, after the patient is put to sleep with general anesthesia, the surgeon will make an incision in the scalp, remove a piece of bone and pull back a section of the tough membrane which covers the brain, called the dura.
Then the surgeon will remove abnormal brain tissue with the use of a microscope to magnify the area. At the end of the surgery, the surgeon will fix back the dura and the bone and close the scalp using stitches or staples.
After surgery, the patient will stay in an intensive care unit for 24 to 48 hours and in a regular hospital room 3 to 4 days. Patients are usually able to return to normal activities in six to eight weeks after surgery.
Most patients continue taking anti-seizure medication but after seizure control is established, medications can be reduced or eliminated.
Lesionectomy is very effective in patients whose seizures are clearly associated with a defined lesion because they usually stop once the lesion is removed.
The side effects of a lesionectomy depend on the location and extent of the lesion, but they generally subside on their own, like:
The risks of a lesionectomy can include failure to relieve seizures, swelling in the brain and damage to healthy brain tissue.
