Awake Brain/Craniotomy Surgery
- incisionary
- Jun 19, 2025
- 2 min read
Brain surgery is a daunting experience that patients face, though it often requires general anesthesia and puts them to sleep so they won’t feel any discomfort or pain. Yet, an emerging technique, known as Awake Brain Surgery or Craniotomy Surgery, has come to fruition. This is a neurological procedure performed on the brain while the patient is awake and alert (Mayo Clinic, n.d.). Unlike traditional brain surgery, where the patient is unconscious, an awake craniotomy allows doctors to interact with the patient in real-time to map and protect vital brain function. This is a procedure that doctors often choose, as it allows brain surgeons to operate with more precision, especially when treating tumors, movement disorders, or epilepsy, while also eliminating risks.
The brain is a delicate organ that controls the entire body. Specific regions control different skills, such as language, speech, and movement. Damage and impact near these areas caused by surgery can significantly affect communication and movement. According to Singh, K., and Dua, A. (2023), awake craniotomy is most commonly used to map and remove tumors found in vital parts of the brain, such as the motor and language cortex. The goal is to remove as much tumor mass as possible without destroying the functional brain tissue. According to the UCSF Brain Tumor Center (n.d), some tumor types that may require this procedure are:
Gliomas (a growth of glial cells that starts in the brain or spinal cord);
Oligodendrogliomas (a brain tumor arising from oligodendrocytes);
Ependymomas (a rare type of brain cancer, primarily found in children, which develops from ependymal cells) and
Brain Metastasis (a secondary brain tumor formed through cancer cells that spread from another part of the body to the brain)
Since the brain has no pain receptors, patients don't feel pain during these procedures; however, keeping them awake allows surgeons to communicate, monitor movement, and detect the patient's responses. Many benefits include reduced need for monitoring, fewer neurological deficits, and reduced postoperative pain, nausea, and vomiting. This is also favorable for patients who don't want to risk their natural talents, such as playing an instrument, singing, art, or reading. Allowing them to do these during the surgery will enable them to stay calm and preserve these talents.
Though this procedure comes with many advantages, there are risks that patients should be aware of. Even with the constant monitoring and communication, complications can still arise. A single wrong move by the surgeon could impact brain function, affecting vision, speech, memory, balance, and coordination. As listed by Mayo Clinic (n.d.), other side effects may include: seizures, stroke, brain swelling, and meningitis.
Despite its fair share of side effects, this procedure has led to the successful treatment of patients, creating an alternative for delicate brain surgeries. With ongoing advancements, awake craniotomy continues to improve, providing better outcomes in neurosurgery.
Written By Sophia Perez at Incisionary
APA References
Mayo Clinic. (n.d.) Awake Brain Surgery.
Singh, K., & Dua, A. (2023, July 6). Anesthesia for awake craniotomy. StatPearls - NCBI Bookshelf.
UCSF Brain Tumor Center. (n.d). Awake Brain Mapping FAQ.
UCSFBrain Tumor Center. (n.d.). Glioma. https://braintumorcenter.ucsf.edu/condition/glioma
UCSF Brain Tumor Center. (n.d.). Oligodendroglioma.
UCSF Brain Tumor Center. (n.d.). Ependymoma.
UCSF Brain Tumor Center. (n.d.). Metastatic Brain Tumor.
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