Surgery while you're awake reduces the risk of damaging critical brain areas that control speech and other skills. Awake brain surgery, also called awake craniotomy, is a type of procedure performed on the brain while you are awake and alert.
Currently, most surgeons around the world conduct this surgery while the patient is awake. You read that right: It's considered standard clinical practice to keep a patient awake for the four to six hours it takes to implant electrodes into specific areas of the brain that control movement.
General anesthesia is frequently used and is especially important for high-precision tumor removal because you must remain absolutely still. Under general anesthesia, you will be unconscious throughout the operation. Some surgeries are done under monitored anesthesia care or sedation.
Pain is usually minimal since there are only a small number of pain nerve endings in the head. Nevertheless, you may experience headaches and other tenderness in the area that was affected.
Awake brain surgery is possible because there are no pain receptors in the brain itself. Your scalp will be anesthetized, so you will not feel the operation or any pain. Read more about awake brain mapping (also called intraoperative mapping).
Most people wake up a few hours after their brain surgery. But sometimes, your surgeon might decide to keep you asleep for a few days after surgery, to help you recover. They use sedatives to keep you asleep. While you are asleep, you might be breathing through a machine called ventilator.
The initial incisions on your head may be sore for about a week afterwards. You may have some mild headaches for a period of about 4-8 weeks as well. If you experience any severe or unusual side effects post-surgery, you should seek immediate, emergency medical care.
As with any brain surgery, awake brain surgery has the potential for risks and complications. These include bleeding, brain swelling, infection, brain damage or death. Other surgical complications may include seizures, muscle weakness, and problems with memory and thinking.
Brain surgery is a major medical event. It carries extra risk. Possible risks associated with brain surgery include: allergic reaction to anesthesia.
Some people recover well after brain surgery, but this can take some time. Other people have some problems, or long term difficulties. The problems you may have depends on the area of the brain where the tumour was (or still is if you only had part of the tumour removed).
During an awake craniotomy, a patient is put under deep twilighting rather than general anesthesia while the doctors get started — the patient is not awake for the incision or when surgeons are opening the skull.
Awake craniotomy, also known as awake brain surgery, is a type of procedure performed on the brain while the patient is awake and able to talk to the operative team. Awake craniotomy was initially used for the surgical treatment of epilepsy and is now most commonly performed for the resection of tumors.
Brain surgery can take anywhere from two to nine hours or more, depending on the complexity of your surgery.
Postoperative coma is not uncommon in patients after craniotomy. It generally presents as mental state changes and is usually caused by intracranial hematoma, brain edema, or swelling. Hyperammonemia can also result in postoperative coma; however, it is rarely recognized as a potential cause in coma patients.
Awake Surgery for Brain Tumors
Awake brain tumor surgery, also known as intraoperative brain mapping, is a procedure performed while the patient is awake but sedated. This allows the neurosurgeon to stimulate part of the brain during the surgery to identify important functional areas to avoid.
You won't need to have your head shaved if you are going to have an operation to remove a pituitary tumour through the nose. For tumours in the brainstem or back part of the brain (cerebellum), your surgeon might only need to shave a small area at the back of your head.
If you're having general anesthesia, an anesthesiologist will give you medications that make you lose consciousness. After the surgery is complete, he or she will reverse the medication so that you regain consciousness — but you won't be wide awake right away.
However, when brain surgery goes wrong, patients can suffer terrible harm. Some die. Others can be left blind, paralysed or disabled.
Most similar studies show an error rate between 1% and 8%, specifically, an adverse event rate between 3.7% and 16.6%,[3,13,17] with about one-quarter to one-half judged as preventable adverse events (errors).
Brain tissue doesn't have any pain fibers, so while you may feel pressure or vibrations from the surgery, you shouldn't feel pain. We use a local anesthetic (similar to those used at a dentist's office) to numb the muscles, skin and bone that the surgeon has to cut through to get to the brain.
In most cases, you'll stay in the hospital for 3 to 7 days after neurosurgery.
To ensure that patients are safe immediately after brain surgery, they generally stay in the hospital for observation anywhere from a few days to over a week. During that time, patients often receive steroids to decrease swelling in the brain and anti-seizure medication to prevent seizures.
Walking after brain injury can be a long and difficult process, but it is achievable with hard work and dedication.
Postoperative delirium in seniors may not be noticeable until a day or two after surgery is complete, but once it hits, you may experience confusion, disorientation, or have problems with your memory or attention span. This delirium comes and goes, but in most cases, it does not last longer than a week or two.
Post-craniotomy headaches (PCH) are one of the most frequently encountered adverse events after craniotomy, presenting in over two-thirds of patients who have undergone the procedure. PCH falls under the category of secondary headaches and can present unique challenges in diagnosis and management.