Awake brain surgery is a procedure performed on the brain the patient is awake and alert. This type of surgery reduces the risk of damaging critical brain areas that control vision, movement, speech, and other skills, when the neurological condition being treated is close to that particular part of the brain.
Awake brain surgery, also known as awake craniotomy, is an effective way to treat certain neurological (brain) conditions such as a tumor or epileptic seizures. Being awake during surgery allows the surgeon to ask questions and request specific movements and monitor brain activity as the patient responds. This is to ensure that these particular areas are still functioning correctly.
Why Is Awake Surgery Used?
This type of surgery is used when a tumor or part of the brain that is causing seizures requires removal, but is located near a functional area of the brain. To avoid damaging these functional areas of the brain the surgeon will need to work carefully and systematically. Since it can be difficult to precisely pinpoint these areas prior to surgery, awake surgery will allow the surgeon to know exactly which areas of the brain are responsible for the problem.
Are There Any Risks with Awake Brain Surgery?
As with any type of surgery, there can be risks and complications. With awake brain surgery, the risks include changes in vision, seizures, thinking and memory problems, muscle weakness, bleeding, brain swelling, infection, brain damage, or even death. However, awake brain surgery offers many advantages and can help to safely remove or reduce the size of growing tumors, prolonging life and improving overall quality of life for patients.
What to Expect During the Procedure
Throughout the procedure, the head is placed in a fixed position to ensure surgical accuracy. Numbing medications will be applied to the scalp enabling the patient to feel comfortable during the procedure. While part of the skull is removed and during reattachment, sedation is required. The following technologies used during awake brain surgery:
- Intraoperative magnetic resonance imaging (iMRI) –precise images of the brain and enables doctors to have accurate information to guide them during surgery.
- Brain mapping with electrical stimulation –enables surgeons to functionally map specific portions of the tumor-involved brain.
- Advanced intraoperative monitoring – monitor neurological cognitive functions, including movement, sensation, complex-problem solving, and language.
- Computer-assisted brain surgery which is guided by a GPS-like 3D brain map. It allows neurosurgeons to safely remove a maximum amount of the tumor and see and remove hidden regions of the tumor not visible to standard MRIs.
After surgery, an MRI may be requested to ensure that removal of the tumor or epileptic focus has been successfully completed. After completion of the procedure, there may be a period of time spent in the intensive care unit and around two to three days of hospital stay are needed. Most patients can return to work and normal activities in 6-12 weeks following the procedure, with a follow-up appointment with the doctor approximately three months after surgery.
Outcomes
If awake brain surgery was carried out to manage epilepsy, reduction in frequency of seizures should be seen after surgery. Some may be seizure-free and others will experience fewer seizures. Occasionally, some people have no change in the frequency of their seizures.
If surgery is carried out to remove a tumor, other treatments, such as radiation therapy or chemotherapy, may still be required to successfully destroy any remaining parts of the tumor.
Neurosurgery in Colorado
At Front Range Spine and Neurosurgery, our board-certified neurosurgeons are experts in both surgical and non-surgical treatments for many neurological conditions and spinal disorders. We are devoted to providing comprehensive, patient-centered care designed to help you achieve the best possible outcomes.
If you would like to learn more about the services we offer or make an appointment with one of our board-certified neurosurgeons, call us today at (303) 790-1800 or you can use our online appointment request form. We have four convenient locations –Lone Tree, Parker, Colorado Springs, and Aurora.
