What Are the Risks and Rewards of Awake Craniotomy Procedures?

Brain surgery may sound intimidating under any circumstances—but imagine being awake during the procedure. Known as an awake craniotomy, this advanced surgical technique is used to safely remove brain tumors or treat conditions located near areas that control critical functions like speech, movement, and memory.

At IGEA Brain, Spine, Pain and Orthopedics, we’re committed to precision and patient safety. For select cases, awake craniotomy offers unique advantages—but like any surgery, it also comes with risks.

What Is an Awake Craniotomy?

An awake craniotomy is a type of brain surgery performed while the patient is conscious for part of the procedure. The skull is opened under anesthesia, but once the brain is exposed, the patient is gently awakened so the surgical team can monitor brain activity in real time.

This approach is often used when a tumor, lesion, or seizure focus is located near eloquent brain areas—regions responsible for language, movement, sensation, or vision.

During the procedure, the patient may be asked to speak, move a limb, count, or perform other tasks. This allows the surgeon to carefully navigate the brain, avoiding areas that control vital functions.

Benefits of Awake Craniotomy

• More precise tumor removal: Surgeons can safely remove as much of the tumor as possible without damaging essential areas.
• Real-time brain mapping: Direct feedback from the patient allows the surgical team to identify and protect critical functions.
• Lower risk of postoperative deficits: Studies show that awake brain surgery may reduce the risk of long-term neurological complications in select cases.
• Better outcomes for tumors near sensitive regions: This approach allows for a more aggressive—but still safe—treatment when tumors are in tricky locations.

Risks and Considerations

• Intraoperative discomfort or anxiety: Patients are awake during part of the procedure, though they are closely monitored and supported throughout.
• Seizures during surgery: Though rare, seizures can occur during brain mapping. The team is prepared to manage this quickly.
• Infection, bleeding, or swelling: These are risks of any brain surgery and are carefully managed through sterile technique and postoperative monitoring.
• Not suitable for all patients: Certain patients—such as those with severe anxiety, cognitive impairments, or very large tumors—may not be good candidates.

Is Awake Brain Surgery Right for You?

Awake craniotomy is a specialized procedure that requires a skilled surgical team and thorough preoperative planning. At IGEA, our neurosurgeons carefully evaluate each patient’s case to determine the safest, most effective surgical approach.

If your condition involves a tumor or lesion near a critical brain region, awake craniotomy may offer better preservation of function and a faster return to normal life.

We’re here to help you make informed decisions about your care—based on advanced imaging, collaborative planning, and a deep understanding of brain anatomy and function.

Contact IGEA to learn more about your surgical options and whether awake craniotomy may be part of your treatment plan.