Neurosurgeons who are highly trained in awake craniotomy and brain mapping use these advanced neurosurgical techniques to protect the eloquent regions of the brain during surgery. Awake patients are able to interact with the neuropsychologist during surgery to better safeguard speech and motor functions.
During an awake craniotomy, after the surgeon has uncovered the affected portion of the brain, the patient is awoken. This allows the neurosurgeon to carefully note which regions of the brain are tied to eloquent functioning. The use of functional magnetic resonance imaging (fMRI) during the procedure further enhances the mapping of the brain’s function.
By combining awake craniotomy and functional mapping, physicians can better protect healthy brain tissue by identifying critical brain functioning tissue and improve surgery outcomes. With this advanced technology, neurosurgeons can now operate on previously inoperable brain tumors.
Surgical treatments that might affect the portions of the brain that oversee the sense, motor, and speech functionality, also called the eloquent brain, can be made safer with functional mapping and awake craniotomy:
Awake surgery provides improved results and protects more neurological capabilities for those with complex brain tumors and other lesions adjacent to the portions of the brain controlling language or motor functions.
Although called awake craniotomy, you will not be awake during the entire procedure. Initially, you will be sedated and your scalp will be numbed. Your surgeon will make an incision to uncover the relevant portion of the skull. A small portion of the bone is temporarily removed, called a skull flap, to create a small window. These smaller keyholes are called burr holes. The membrane covering the brain is delicately incised and the brain is exposed.
At this point, you will be awakened. The neuropsychologist will coordinate with the neurosurgeon to guide you through the functional mapping process. By assessing your reported sensations, speech and movement, your neuropsychologist and surgeon can ascertain the regions of the lesion that could interfere with critical brain functions.
Using sophisticated computer imaging, your doctor creates scans during this advanced mapping process that can be used to help plan or assist during brain surgery.
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