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Preparing for Brain Surgery

To identify the exact location of the tumor and plan the brain surgery procedure, the neurosurgeon will order imaging tests as needed. The following are examples of imaging a patient might undergo:

  • Magnetic resonance imaging (MRI)
  • Computerized tomography (CT or CAT scan)
  • Angiogram
  • Functional MRI (fMRI)
  • Diffusion tensor imaging (DTI)

These images provide a road map to the best way to reach the patient's tumor and see it in relationship to vital areas of the brain. The neurosurgeon will use the map to plan the procedure to avoid areas of the brain associated with key functions.

About Fiducials

If you are undergoing brain surgery, your Johns Hopkins neurosurgeon may be using fiducial markers to target certain areas for surgical resection or treatment.

Fiducials are small stickers that look like white doughnuts. They are painlessly affixed to your scalp before your operation by a member of your radiology team.

Before your surgery, a CT or MRI scan with the fiducials in place creates a 3-D map of your head. During surgery, the fiducials provide a series of reference points for your surgeon and integrate navigation during surgery with the 3-D map.

This imaging-assisted technique helps your surgeon safely find the way around your brain and precisely locate tumors, targets for deep brain stimulation and other lesions in three dimensions as he or she works, almost like a GPS system.

You may be scheduled to have your fiducials attached a day or two before your surgery. It's important not to disturb or remove them. Ask your surgeon when he or she plans to attach them, since you cannot shower or wash your hair once they are in place. They will be removed once your operation is complete.

Learn more about advanced imaging and surgical techniques used during brain surgery.

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