Awake Craniotomy & Mapping
Awake Craniotomy is a highly specialized neurosurgical procedure performed while the patient is awake (but pain-free) for a part of the surgery.
It is primarily used when a brain tumour or other lesion lies close to regions that control speech, movement, sensation, or vision.
By keeping the patient awake and responsive, the neurosurgeon can directly assess brain functions in real time, ensuring the maximum safe removal of the tumour while preserving vital neurological abilities.
This technique is often combined with brain mapping — a process that helps the surgeon identify and protect critical brain areas (known as “eloquent cortex”).
Why Awake Craniotomy is Performed
Many brain tumours, epileptic foci, or vascular malformations are located near parts of the brain responsible for speech, language, movement, memory, or vision.
Traditional surgery under deep anesthesia can make it difficult to monitor these functions during tumour removal.
Awake craniotomy allows:
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Continuous testing of speech, movement, and other functions during the procedure.
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Safe resection of tumours in highly sensitive areas.
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Preservation of quality of life by minimizing neurological deficits.
Conditions Commonly Treated with Awake Craniotomy
Awake craniotomy and brain mapping are often recommended for:
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Gliomas and Glioblastomas located in speech or motor areas.
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Low-Grade and High-Grade Tumours in eloquent regions.
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Epilepsy Surgery to remove seizure-causing brain tissue.
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Arteriovenous Malformations (AVMs) or other vascular lesions near functional brain regions.
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Re-operations where previous surgery has altered normal anatomy.
How the Procedure Works
1. Pre-Surgical Preparation
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Detailed MRI, fMRI, and diffusion tensor imaging (DTI) scans are done to plan surgery and visualize important pathways.
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The patient is thoroughly counseled and trained for the awake phase.
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An anesthesiologist ensures comfort and safety throughout the procedure.
2. The Surgery
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The operation begins with the patient under sedation and local anesthesia for a painless experience.
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Once the skull is opened, sedation is lightened, and the patient is gently awakened.
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The neurosurgeon uses brain mapping techniques — such as direct electrical stimulation — to identify critical areas for speech, movement, or sensation.
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The tumour is then removed while the patient performs simple tasks (like speaking, counting, or moving fingers), helping guide safe tumour resection.
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After critical parts are removed, the patient is again sedated for wound closure.
Brain Mapping Explained
Brain mapping involves stimulating specific areas of the brain surface during surgery while observing immediate effects (like speech hesitation or limb movement).
This allows the surgical team to create a real-time “functional map” that shows which areas must be preserved.
Benefits of intraoperative brain mapping include:
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Maximizing tumour removal while protecting essential functions.
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Reducing the risk of speech loss, paralysis, or sensory impairment.
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Improving long-term neurological outcomes and quality of life.
Advantages of Awake Craniotomy & Mapping
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Enhanced Safety: Continuous monitoring reduces the risk of damaging critical areas.
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Better Tumour Removal: Helps achieve a higher extent of safe tumour resection.
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Preservation of Functions: Protects speech, movement, and other vital abilities.
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Faster Recovery: Patients often recover sooner with fewer long-term deficits.
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Improved Quality of Life: Reduces postoperative disability and dependency.
Patient Experience
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The idea of being awake during surgery may feel intimidating, but patients are completely comfortable and pain-free due to modern anesthesia techniques.
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A dedicated team — including the neurosurgeon, neuroanesthesiologist, and speech/functional testing specialists — supports the patient throughout the procedure.
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Patients often report feeling reassured because they are active participants in protecting their own brain functions.
Why Choose Our Centre
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Expert Neurosurgeon & Neuro-Oncosurgeon: Experienced in performing complex awake surgeries with excellent outcomes.
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State-of-the-Art Technology: Includes advanced neuronavigation, intraoperative neuro-monitoring, fMRI-based planning, and high-resolution operating microscopes.
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Multidisciplinary Team: Seamless collaboration between neurosurgeons, anesthesiologists, speech therapists, and rehabilitation experts.
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Patient-Centric Care: We provide personalized preparation, compassionate support, and focused rehabilitation to ensure optimal recovery.
Recovery & Follow-Up
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Most patients spend only a short time in the ICU for monitoring before moving to the ward.
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Speech, motor, and cognitive assessments are done soon after surgery.
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Rehabilitation support (such as speech or physiotherapy) is provided as needed.
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Regular follow-ups and imaging help monitor healing and tumour control.