Surgery remains the ‘mainstay’ of treatment for brain tumours. It is supported by radiation therapy and chemotherapy if the biopsy turns out to be a malignant lesion (tumour). Benign tumours are almost totally removed by microsurgical / endoscopic means except in those few cases where it involves blood vessels, cranial nerves and other vital structures whose damage can be permanent or sometimes life threatening. In such cases the neurosurgeon resorts to subtotal/near total removal of the remour and give radiation for the residual part, and this happens to be an internationally accepted norm. Stereotactic surgery/biopsy is done for those deep seated tumours for getting at the diagnosis (pathology) so that other forms of therapy can be instituted. Apart from conventional radiation therapy, X knife, gamma knife and cyber knife radiation therapy are available now for treating the residual tumours. Many of these microsurgery and endoscopic assisted surgeries are done with intraoperative neurophysiological monitoring so that damages to the vital neural structures are minimised.

The ultimate prognosis and outcome depends on the nature of the tumour. Benign tumours when removed totally by surgical means offers the best results with very low recurrence rates. However the prognosis and long term survival varies in cancerous (malignant) tumour, and it entirely depends on the grade / stage of the tumour. The higher the grade of malignant tumour, the poorer the outcome and long term survival. Early diagnosis and prompt surgical treatment paves way for an excellent outcome and longevity.