Awake Craniotomy (Brain Surgery)

What is an awake craniotomy?

An awake craniotomy is open brain surgery to remove tumours or a section of the brain where seizures occur. These brain sections are often within, or close to, critical regions of your brain. These regions typically control important bodily functions or your sensory and linguistic skills.

It is important that you are conscious during parts of the procedure so that your surgeon can monitor your neurological functions closely. Although you will be awake, you will not feel any discomfort because a local anaesthetic will be applied to fully numb the area, and sedation will be provided.

Why do you need an awake craniotomy?

An awake craniotomy is especially beneficial for some brain tumours and epilepsy. The procedure allows the team to:

  • Identify critical areas of the brain to avoid during the surgery
  • Remove or treat brain tumours that are within or near critical regions of the brain

If not for awake craniotomy, certain conditions may be considered inoperable due to the risks of damaging critical areas of the brain.

Who should not undergo an awake craniotomy?

An awake craniotomy may not be suitable for a patient who is unable to communicate during the surgery. This may be due to severe symptoms of an existing condition, such as severe sleep apnoea.

Without responsive feedback from the patient during the procedure, the surgical team will not be able to map their brain accurately. This will affect the outcomes of the surgery.

Your doctor will help to determine if you are a suitable candidate for this procedure.

What are the risks and complications of an awake craniotomy?

Your doctor will explain the degree of risk in your case, as it depends on a number of factors. These include the severity of your condition, the size and location of the tumour and your general health.

Complications may include:

  • Memory loss
  • Fits or seizures
  • Speech or learning difficulties
  • Coordination and balance impairments
  • Cerebrospinal fluid (CSF) leak
  • Muscle weakness
  • Brain swelling
  • Meningitis

Generally, the incidence of serious complications causing a permanent stroke or death is low. The risks of surgical and medical complications are also thought to occur less frequently in awake craniotomy.

This page has been reviewed by our medical content reviewers.

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