Conscious/Awake Brain Surgery

An awake craniotomy, also known as conscious brain surgery, is precisely as it sounds: a brain surgery during which you are awake. That might sound like something out of a science fiction novel, but the Intent Medical Group experts, led by Dr. Amin Kassam, have engineered this surgical procedure with great success. When your condition requires brain surgery, your surgeon’s goal is to preserve your most important brain functions—the parts of your brain that make you who you are. This includes your memories, emotions, and cognition. Conscious brain surgery allows surgeons to do just that, while making you very comfortable during the procedure.

What is conscious/awake brain surgery?

During conscious brain surgery, a patient is not just awake, but they are able to think and converse throughout the procedure. The technique requires only local anesthesia and minimal doses of IV medications to keep the patient comfortable. The surgical team is then able to monitor the patient’s thought processes, memory, and speech during the surgery in order to promote better surgical outcomes.

As an engineer of this innovation in surgical technology, Dr. Kassam published the first report of conscious surgery of the upper brainstem and third ventricle, among the most challenging areas to access in the human brain. His research and dedication to this advanced surgical innovation has allowed surgeons to use a relatively small incision to target pathology far more efficiently than in unconscious surgical procedures.

If your treatment plan includes brain surgery, you may be frightened, and conscious surgery may feel like an overwhelming option. At the Endeavor Health Advanced Neurosciences Center, your Intent Medical Group surgical team will ensure you are pain-free and calm throughout the procedure. You will be asked questions and may even engage with loved ones over the phone. As the surgery progresses, the team will determine how your brain activity is affected. For instance, they can monitor your response to visual stimulation, the impact on your language, and your ability to retrieve memories. You may be asked to move parts of your body, describe pictures, or identify letters and numbers. Each response provides the team with valuable information about your brain functions.

Which diagnoses are candidates for conscious/awake brain surgery?

Awake craniotomy is used when a patient’s quality of life is impacted by a tumor or other pathology. When surgery is performed near an area of the brain where cognition or motor skills originate, the team needs to understand the impact of the surgeon’s every move. Among the diagnoses/pathologies where this highly technical surgery is considered essential are:

• Epilepsy
• Tumors in the brain such as gliomas, oligodendroglioma, ependymoma, and brain metastasis (these are located near sections of the brain that control motor, sensation, and language functions)
• Vascular malformations

The decision to pursue conscious brain surgery also depends on the tumor’s size and the patient’s general health.

What happens after conscious/awake brain surgery?

Depending on the reason for this procedure, recovery time may differ. If you have epilepsy, you may experience reduced or eliminated seizure activity. In the case of a tumor, you may require follow-up radiation or other treatment.

After surgery, your physician may request an MRI (magnetic resonance imaging) scan to ensure that the surgical site is free of pathology. You will likely remain under hospital care for a few days so that the recovery team can monitor your healing progress.

If your treatment plan includes brain surgery, you may be overwhelmed and frightened. With our globally renowned team and extraordinary experience with the most advanced technology, the Intent Medical Group team at the Endeavor Health Advanced Neurosciences Center will be there for you through every step of your recovery.