Brain tumor surgery is a procedure to remove a mass of unhealthy cells in the brain. There are many different types of primary brain tumors. Some brain tumors are not cancer — these are called noncancerous or benign brain tumors. Noncancerous brain tumors may grow over time and press on the brain tissue. Other brain tumors are brain cancers, also called malignant brain tumors, which may grow quickly and invade or destroy brain tissue.

Brain tumors range in size from very small to very large. Some are found when they are very small because they cause symptoms right away. Others grow quite large before they're found, particularly in less active areas of the brain.

The goal of brain tumor surgery is to remove the entire tumor without damaging the healthy brain tissue around it. Sometimes, surgeons may only be able to remove part of the tumor. Some patients may only need surgery, while others require additional treatments such as radiation therapy or chemotherapy.

Cranioplasty is a neurosurgical procedure that repairs skull defects caused by trauma, previous surgery (like decompressive craniectomy), or congenital conditions. It involves covering the gap with the patient's own bone (autologous) or synthetic material (e.g., titanium or PEEK) to protect the brain, restore skull contour, and improve neurological function.

The surgery usually involves lifting the scalp to fit the implant and securing it to the cranium. A well-performed cranioplasty not only protects the brain from injury but can also lead to neurological improvements by restoring normal intracranial pressure dynamics.

Dr. Robles has published research on autologous cranioplasty techniques, including work on bone flap preservation in conventional freezers — an important option in resource-limited settings.

Chiari malformation is a structural defect in which the lower part of the brain (cerebellum) descends into the spinal canal, causing pain and neurological symptoms due to pressure on the brainstem. Common symptoms include severe headaches (often triggered by straining), neck pain, dizziness, balance issues, and weakness. Diagnosis is confirmed via MRI.

Chiari malformation surgery — typically a posterior fossa decompression — aims to relieve pressure on the brainstem and cerebellum by removing a small section of bone at the back of the skull and sometimes the top vertebrae. This creates more space and reduces compression.

Dr. Robles has published case reports on Chiari malformation, including presentations in children and cases with associated syrinx (fluid-filled cavity in the spinal cord).

Hydrocephalus is a chronic neurological condition caused by an abnormal buildup of cerebrospinal fluid (CSF) in the brain's cavities (ventricles), causing them to enlarge and put pressure on brain tissue. It is commonly caused by blockages, poor absorption, or overproduction of CSF.

Symptoms vary by age:

• Infants: Rapidly increasing head circumference, bulging fontanelle, prominent scalp veins, irritability, "sunset eyes"
• Children & Adults: Headaches (worse in the morning), nausea, vomiting, blurry or double vision, cognitive difficulties, gait disturbances
• Normal Pressure Hydrocephalus (NPH): Triad of walking difficulties, urinary incontinence, and dementia-like cognitive decline

While hydrocephalus cannot be cured, it can be treated — typically through surgical insertion of a shunt, a system that drains excess CSF to another part of the body (usually the abdomen).

Surgery for head trauma treats severe traumatic brain injuries (TBI) by relieving intracranial pressure, stopping bleeding, or repairing skull fractures. Common procedures include craniotomy to remove blood clots or repair damage, and decompressive craniectomy to manage severe swelling.

Common surgical procedures for head trauma include:

• Craniotomy: A surgical opening in the skull to access the brain, remove hematomas (blood clots), repair damaged tissue, or stop bleeding
• Decompressive Craniectomy: A portion of the skull is removed and left off to allow the brain to swell outward and reduce pressure on the brainstem
• Burr Hole Surgery: Small holes drilled into the skull to drain fluids or blood clots, often used in emergencies
• Skull Fracture Repair: Reconstructing and stabilizing fractured bone fragments, particularly for depressed fractures

When a brain bleed occurs, a blood vessel leaks blood or bursts. Blood collects within your skull and brain, creating pressure that prevents oxygen and nutrients from reaching brain tissues and cells. A brain bleed is a life-threatening medical emergency.

A brain bleed can happen after: head trauma, atherosclerosis, a blood clot, a cerebral aneurysm (weak spot in a blood vessel wall), arteriovenous malformation (AVM), cerebral amyloid angiopathy, or a brain tumor.

Treatment varies based on the severity and location of the bleed. Your surgeon will focus on stopping the bleeding and managing the cause. Treatment may include surgery or medications. Prompt surgical intervention can be life-saving.