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Seizures, deficits or adjuvant therapy delay this."},"follow_up_visits":[{"purpose":"wound_check","requirement":"routine","after":{"min":10,"max":14,"unit":"days","qualifier":"Wound inspection and suture or staple removal."}},{"purpose":"result_review","requirement":"routine","after":{"min":14,"max":28,"unit":"days","qualifier":"Review of pathology results and planning of any adjuvant treatment."}},{"purpose":"assessment","requirement":"routine","after":{"min":60,"max":120,"unit":"days","qualifier":"Neurological assessment and postoperative MRI, then periodic surveillance imaging."}}],"indications":["Symptomatic or growing resectable brain tumor, benign or malignant","Tumor causing raised intracranial pressure, seizures or focal deficits","Need for tissue diagnosis and cytoreduction","Meningioma, glioma, metastasis or similar operable lesion"],"main_risks":["Bleeding or hematoma","Infection (wound, meningitis)","New or worsening neurological deficit","Seizures","Brain swelling","Cerebrospinal fluid leak","Venous thromboembolism","Anesthetic complications","Hydrocephalus"],"pain":"Moderate headache and incision pain for the first several days, usually controlled with analgesics; typically eases within 1-2 weeks.","preparation":["MRI (often navigation protocol) and other imaging","Preoperative blood tests and anesthetic assessment","Neurosurgical consultation and informed consent","Review of current medications with surgical team","Fasting before general anesthesia","Hair clipping at surgical site on surgery day","Arrange support for hospital stay and recovery","Steroids and antiepileptics only if prescribed","Anticoagulants or antiplatelets: change only on clinician instruction"],"recovery_timeline":[{"phase":"Hospital stay (days 0-7)","description":"Neurological monitoring, early mobilization, postoperative imaging, pain and swelling control.","restrictions":["No driving"]},{"phase":"Early home recovery (weeks 1-4)","description":"Gradual increase in walking, wound healing, fatigue management, suture removal around 10-14 days.","restrictions":["No heavy lifting or straining","No driving until cleared","Keep wound dry and clean"]},{"phase":"Intermediate recovery (weeks 4-12)","description":"Return to light work and daily activity as energy and neurological status allow; discussion of adjuvant therapy if needed.","restrictions":["Avoid strenuous exercise and contact activities until cleared"]},{"phase":"Late recovery (3-12 months)","description":"Ongoing neurological recovery and surveillance imaging.","restrictions":[]}],"rehabilitation_days":{"min":28,"max":84,"unit":"days","qualifier":"Ordinary functional recovery to daily activities after uncomplicated resection; longer if neurological deficits require therapy."},"result_longevity":"Depends on tumor type and extent of resection. Benign tumors like meningioma are often controlled long term; glioma and metastasis often recur, needing adjuvant therapy and surveillance imaging.","revision_rate_pct":{"min":4,"max":6,"unit":"percent","qualifier":"Unplanned return to surgery within 30 days of primary craniotomy (about 4.8%). Later recurrence surgery excluded."},"scars":"Scalp incision scar, usually curved or linear and partly hidden by hair; a shaved or clipped area regrows within weeks to months.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"Single craniotomy operation for resection."},"stages":[{"code":"craniotomy_resection","label":"Craniotomy and tumor resection","after":{"min":0,"max":0,"unit":"days","qualifier":"Performed at the initial surgery."}}],"qualifier":"Standard single-stage craniotomy; adjuvant therapy and follow-up are separate."},"success":{"metric":"Gross total resection achieved on postoperative MRI","value":70,"unit":"percent of patients","horizon":"Within 72 hours after surgery","population":"Adults with resectable supratentorial tumor, such as meningioma or metastasis, in non-eloquent areas","evidence_status":"limited"},"techniques":[{"name":"Open craniotomy with microsurgical resection","suits_whom":"Most accessible supratentorial and posterior fossa tumors.","recovery":"Hospital stay about 3-7 days; return to light activity over several weeks."},{"name":"Neuronavigation or fluorescence-guided resection","suits_whom":"Gliomas and tumors near eloquent areas needing precise margins.","recovery":"Similar to standard craniotomy."},{"name":"Awake craniotomy","suits_whom":"Selected tumors in language or motor areas.","recovery":"Similar to standard craniotomy; may reduce deficit risk."},{"name":"Endoscopic endonasal approach","suits_whom":"Pituitary and some skull base tumors.","recovery":"Often shorter stay, about 2-4 days."}],"treatment_conditions":["inpatient"],"treatment_duration_hours":{"min":3,"max":8,"unit":"hours","qualifier":"Operative time for one standard craniotomy for tumor resection, excluding anesthesia preparation and recovery."},"initial_assessment_documents":["Brain MRI with contrast","Brain CT scan report (if available)","Biopsy or pathology report (if available)","Recent neurological examination report","List of blood thinners and anti-seizure drugs","Previous brain surgery or radiotherapy records (if available)"],"travel_trips":{"min":1,"max":1,"one_trip_possible":true,"qualifier":"Single-stage craniotomy; stay 3-7 nights in hospital, then about 2-6 weeks before flying home. Follow-up can be done at home."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Ask whether the surgeon has operated on someone with your tumor type before","scope":"procedure","source":{"url":"https://www.cancer.gov/rare-brain-spine-tumor/living/questions/neurosurgeon","host":"cancer.gov","quote":"Have you performed surgery on someone with my tumor type before?","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C2","text":"Ask how many people with your tumor type the surgeon operates on each year","scope":"procedure","source":{"url":"https://www.cancer.gov/rare-brain-spine-tumor/living/questions/neurosurgeon","host":"cancer.gov","quote":"If so, how many people with my tumor type do you perform surgery on each year?","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C3","text":"Check that the surgeon you consult is the same person who will carry out the operation","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Check that the surgeon you consult with, will be the same person carrying out the procedure.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C4","text":"Check that the surgical team has received and reviewed your full medical record","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Make sure the surgical team has received your full medical record and reviewed it","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C5","text":"Check the qualifications of the medical team that will treat you","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Have you checked the qualifications of the medical team treating you?","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C6","text":"Check whether the facility and its professionals hold accreditation or certification, because some abroad may lack it","scope":"treatment_abroad","source":{"url":"https://www.cdc.gov/yellow-book/hcp/health-care-abroad/medical-tourism.html","host":"cdc.gov","quote":"Some facilities and healthcare professionals abroad might lack accreditation or certification.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":403}},{"id":"C7","text":"Check whether follow-up care is scheduled at the same facility as the procedure","scope":"treatment_abroad","source":{"url":"https://www.cdc.gov/yellow-book/hcp/health-care-abroad/medical-tourism.html","host":"cdc.gov","quote":"Medical tourists should also know whether follow-up care is scheduled to occur at the same facility as the procedure.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":403}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"Advertising or information that promises complete success is a warning sign","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Any advert or information that guarantees complete success should raise concerns.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"F2","text":"Pressure to decide quickly, or cheap offers that expire soon, is a warning sign","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Don’t be pressured into quick decisions either through forceful persuasion or cheap, time limited offers.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"F3","text":"Medical advice offered by sales staff or agents, rather than clinicians, is a warning sign","scope":"treatment_abroad","source":{"url":"https://travelhealthpro.org.uk/news/699/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Do not accept advice from a travel agent, sales representatives or administrators.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"warning_signs":{"status":"ok","items":[{"id":"W1","text":"Seizure lasting more than five 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had.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T3","text":"Home doctor needs the dates for required blood tests and follow-up appointments","document":"written aftercare plan","source":{"url":"https://sbuhb.nhs.wales/about-us/individual-patient-commissioning/ipc-folder/advice-on-accessing-treatment-abroad","host":"sbuhb.nhs.wales","quote":"This should include any medication and doses, as well as any dates that blood tests and follow-up appointments must be carried out.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T4","text":"Home doctor needs the clinic's follow-up recommendations in a written discharge summary","document":"discharge summary","source":{"url":"https://sbuhb.nhs.wales/about-us/individual-patient-commissioning/ipc-folder/advice-on-accessing-treatment-abroad","host":"sbuhb.nhs.wales","quote":"When you have treatment abroad, you must ask the treatment provider for their follow-up recommendations documented 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