What Is Awake Craniotomy?
Awake craniotomy, also known as awake brain surgery, is a specialized surgical procedure performed while the patient is awake and conscious.
This advanced surgical technique allows neurosurgeons to monitor and protect critical brain functions during the operation.
By engaging the patient during the procedure, surgeons can ensure the safe removal of brain tumors, epileptic foci, or other abnormalities without damaging essential brain areas responsible for speech, movement, and vision.
Conditions Treated with Awake Craniotomy
Some brain (neurological) diseases, such as some brain tumours or epileptic seizures uncontrolled by medications, DBS for Parkinson’s disease, surgery for spasticity, surgery for some psychiatric disorders not controlled by medication are treated via awake brain surgery.
Awake craniotomy is often used to treat complex neurological conditions, including:
- Brain Tumors: Particularly those located near eloquent brain areas, such as motor, language, or visual regions.
- Epilepsy: Cases where seizures are not controlled by medication and require precise localization of the epileptic focus.
- Deep Brain Stimulation (DBS): For treating conditions like Parkinson’s disease.
- Spasticity Surgery: In patients with severe muscle stiffness or spasms.
- Psychiatric Disorders: Cases resistant to conventional treatments.
Why Is Awake Craniotomy Advised?
The primary goal of an awake craniotomy is to preserve critical brain functions while treating the underlying neurological condition. Key areas targeted for protection include:
- Motor Areas: Responsible for movement.
- Language Areas: Critical for speech and communication.
- Sensory Areas: Involved in processing sensory inputs like touch and vision.
This approach minimizes the risk of post-surgical complications, such as loss of speech, movement difficulties, or vision impairment.
The benefit of Awake Craniotomy.
Your comments will assist your surgeon in ensuring that the proper portion of your brain requires surgery. The surgery also reduces the chance of functional brain damage, which can impede your vision, mobility, and speech.
- Enhanced Safety: Awake craniotomy ensures the surgeon avoids damaging critical brain regions.
- Real-Time Feedback: The patient’s responses during surgery guide the surgeon in identifying functional areas of the brain.
- Improved Outcomes: The risk of functional impairments is significantly reduced, enabling a faster recovery.
- Precise Tumor Removal: Allows surgeons to maximize tumor resection while preserving neurological functions.
- Reduction in Seizures: In cases of epilepsy, awake craniotomy often results in fewer or no seizures post-surgery.
Why Awake Craniotomy Is Performed
Doctors must ensure that they do not damage the eloquent part of the brain if a tumour or section of your brain that causes seizures needs to be surgically removed.
Prior to surgery, it’s tough to locate such locations precisely. Awake brain surgery helps the surgeon pinpoint which parts of your brain regulate particular functions, allowing them to avoid them.
How Is Awake Craniotomy Performed?
For sections of your awake brain surgery-Awake Craniotomy, the anesthesiologist will give you medicine to make you sleep. To guarantee your comfort, the neurosurgeon will administer numbing drugs to your scalp.
Doctors put your head in a set position during the surgery to keep it motionless and enhance surgical precision. Your hair will be trimmed in some places. After that, your surgeon will remove a portion of your skull to have access to your brain.
You’ll be given medication and asleep as a small portion of your skull is taken at the start of the procedure, as well as when physicians reattach it at the end of the procedure. Your anesthesiologist will cease giving you sedative drugs during surgery and enable you to wake up.
Your doctor will undertake brain mapping if your brain tumour or epileptic focal is close to parts of your brain that regulate vision, speech, or movement. This offers a map of the brain centre’s that govern each of these functions to your neurosurgeon. During surgery, your surgeon may be able to undertake brain mapping deeper in your brain.
This map is used by your neurosurgeon to avoid injuring certain locations and to keep their functions intact. Your surgeon can safely remove as much of your brain tumour or epileptic focus as feasible using brain mapping and 3-D computer pictures, reducing the risk of disrupting vital bodily processes.
Your medical team will also employ comprehensive 3-D computer scans of your brain, including intraoperative MRI and computer-assisted brain surgery, to guide the removal of as much of the brain tumour or epilepsy focal as feasible before and during surgery.
Anaesthesiologist and surgical team closely monitor and analyse your body and brain functioning, alerting your surgeon if the operation has a negative impact on your brain function.
Outcomes of Awake Craniotomy
- For Epilepsy: Many patients experience a significant reduction in seizures post-surgery, with some achieving complete seizure freedom.
- For Tumors: The procedure allows for maximum removal of the tumor while preserving vital brain functions. Additional treatments, like chemotherapy or radiation therapy, may be required for residual tumor cells.
Summary:
If you have awake brain surgery-Awake Craniotomy to treat epilepsy, you should notice a reduction in your seizures following the procedure. Some patients have no seizures at all, while others have fewer seizures than they did before the procedure.
Your neurosurgeon should have been able to remove the majority of the tumour if you had awake brain surgery to remove it. Other therapies, such as radiation therapy or chemotherapy, may be required to help eliminate any residual tumour cells.
FAQs About Awake Craniotomy
FAQs About Awake Craniotomy
1. What is awake craniotomy?
Awake craniotomy is a type of brain surgery performed while the patient is awake to preserve critical brain functions like speech and movement during the procedure.
2. Why is awake craniotomy necessary?
This surgery ensures that essential brain areas are not damaged during procedures like tumor removal or epilepsy treatment.
3. Is awake craniotomy painful?
No, numbing medications and careful monitoring by the anesthesiologist ensure the procedure is painless.
4. What conditions are treated with awake craniotomy?
Awake craniotomy is used to treat brain tumors, epilepsy, Parkinson’s disease, spasticity, and certain psychiatric disorders.
5. How long does recovery take after awake craniotomy?
Recovery varies by patient, but most individuals can return to normal activities within weeks, depending on the complexity of the surgery.
6. Are there risks associated with awake craniotomy?
As with any surgery, there are risks, including infection, bleeding, or neurological deficits. However, awake craniotomy minimizes these risks by preserving essential brain functions.
7. How do I prepare for awake craniotomy?
Your medical team will provide detailed instructions, including tests, fasting guidelines, and pre-surgical counseling to ensure you are mentally and physically prepared.