[Neuro-oncology and Skull Base]
When is awake brain surgery preferred?
Operating on tumours next to the speech and movement areas while these functions are monitored during surgery.
about 4 min read
Answer:
Awake brain surgery (awake craniotomy) is a special surgical method preferred mainly for tumours located close to areas that control important functions such as speech, movement, memory and vision. It can also be used in some epilepsy operations and in selected cases of vascular malformations (AVMs).
The main aim is to communicate with the patient during the operation, assess the critical areas of the brain in real time, and protect healthy tissue as much as possible. This method gives us a very important advantage, especially in operations near the speech centre or the areas that control arm and hand movements.
Key Message:
“Our aim is not only to remove the disease, but also to protect the patient’s speech, movement and quality of life.”
What are the advantages of the patient being awake during the operation?
Answer:
Having the patient awake allows us to assess the functional map of the brain in real time. During the operation, we can talk with the patient and carry out tests such as counting, naming objects or moving the arms and legs.
In this way, we check the critical areas of the brain in real time and define safe surgical boundaries. This approach is especially valuable in tumour surgery, because we aim both to remove the tumour effectively and to reduce risks such as paralysis or speech problems.
Key Message:
“Awake surgery allows us to navigate the brain using the patient’s own functions.”
Does the patient feel pain in this type of surgery, and how is the process managed?
Answer:
This is one of the most frequently asked questions. The brain tissue itself does not feel pain. For the patient’s comfort, the scalp is numbed with special anaesthetic techniques, and an experienced anaesthesia team monitors the patient closely throughout the operation.
The patient is not left under stress. Light sedation can be given when needed, and we stay in constant communication with the patient. For this reason, when the patient is suitable for this method, the process is much more controlled and comfortable than people may imagine.
Key Message:
“Being awake does not mean feeling pain; we manage a controlled and comfortable process.”
Are the risks of this operation different from those of conventional brain surgery?
Answer:
As with any brain surgery, there are certain risks here too. However, one of the most important advantages of awake surgery is that we can assess neurological functions such as speech and movement live during the operation.
For this reason, when it is performed in the right patient, we can reduce the risk of losing neurological function. Of course, patient selection is very important. Some patients with severe anxiety or difficulty communicating may not be suitable for this method.
Key Message:
“With awake brain surgery performed in the right patient, patients can continue their lives with confidence while preserving their speech, movement and quality of life.”
How does recovery usually go after the operation?
Answer:
Although recovery varies depending on the extent of the operation and the patient’s general condition, we can assess many patients neurologically in the early period after surgery and get them up and walking within a short time.
Another important advantage of awake surgery is that we can see immediately during the operation whether speech and movement functions have been preserved. Patients can usually reach a level where they can return to daily life within a few days.
Key Message:
“The measure of a successful operation is not only the scan images, but the patient’s ability to continue their life with confidence.’’