The growth and formation of abnormal cells that occur in copying during the regeneration of brain cells is called a brain tumor. Brain tumor, which can be seen at any age, from newborns to older adults, causes pressure inside the skull. This pressure and pressure makes the brain unable to perform its task entirely, and patients show various symptoms. In particular, severe and prolonged headache, seen in approximately 60% of patients, is one of the essential symptoms.

Early diagnosis is of great importance in brain tumors, which are generally classified as benign and malignant. Since not every brain tumor has a lethal effect, correct intervention and early diagnosis are crucial in curing tumors. Doctors can control the tumors thanks to early diagnosis and new treatment methods that have emerged with the development of medicine. One of these treatment methods is awake brain tumor surgery.

What Is Awake Brain Tumor Surgery?

Awake brain tumor surgery, as the name suggests, is the method in which the patient is awake during the surgery. Accordingly, it allows crucial functions such as speech and arm and leg movements to be followed during surgery. In this way, it is a method that aims to minimize the risks such as post-operative speech disorder and paralysis. Doctors can perform this procedure on brain tumors in any location according to the relevant function.

In Which Diseases Are Awake Brain Tumor Surgery Used?

In modern neurosurgery practices, awake brain tumor surgeries are the method used in the surgery of brain tumors located in the brain’s speech center. Because the need to perform awake tumor surgery in the surgery of tumors in other regions is not required, thanks to the modern technologies available. However, suppose the tumor location is in the speech center, In that case it becomes a necessity to perform awake brain tumor surgery since it is not possible with the available technologies to monitor it during surgery under general anesthesia.

How Is Awake Brain Tumor Surgery Performed?

Today, there are several variants of performing world-class awake brain tumor surgery. In the wake-up brain tumor surgery performed in Turkey and currently accepted in the world, the surgeon makes a brain mapping of the patient’s speech cortex, that is, the part of the brain related to speech, during the operation, before the tumor removal process is started. It maps with a method called Speech arrest. Selects the region that will not or at least affect the speech. During the tumor removal, the patient’s address functions are monitored throughout the surgery. At the same time, in addition to this technology, the yellow-560 tumor staining method separates the tumor tissue from the normal tissues. It reduces the risk of deterioration of the patient’s speech after the surgery by below 1%.

What Are The Advantages Of Awake Brain Tumor Surgery?

Speech function cannot monitor while the patient is asleep. Because although the speech center in the brain is in 2 regions, it is in communication with all other centers simultaneously. Therefore, awake surgeries provide significant advantages, especially in speech-centered tumors.

Is Pain Felt In Awake Brain Tumor Surgery?

There are no pain fibers in the human brain. Therefore, the brain did not feel pain while operating in the brain. But the human skull, bone, and cerebral cortex carry pain fibers. For this reason, even if awake surgery is to be performed, the patient is put to sleep at the beginning of the operation, these layers are passed under anesthesia so that those areas do not feel pain, and the patient is awakened after the cerebral cortex is opened. Since there is no pain in the procedures performed in the brain, the patient does not feel any pain or pain. After the surgery, the patient is put back to sleep during the closure phase.

Which Patients Are Suitable For Awake Brain Tumor Surgery?

There are tumor-related and patient-related factors in deciding on awake surgeries. If the patient’s tumor is in the speech center, it is suitable for awake surgery, still if the patient has serious concomitant diseases such as heart, uncontrolled hypertension, or uncontrolled diabetes, it is not ideal for awake surgery. Some patients do not want to have awake surgery. The choice of awake surgery would not be correct for patients who are not ideal for this psychiatric condition. In addition, patients who need to be operated on in the prone position are unsuitable for awake surgery.

What Are The Risks Of Awake Brain Tumor Surgery?

The most significant limitation is the lower percentage of removal of the entire tumor. More is needed not enough to prefer the vigilant method. During the speech arrest surgery, our consultants should determine the speech center  before the operation is started with the technology in which the brain is stimulated with electrical stimulation, and the speech region is mapped. It can be activated by planning the operation by stopping the speech with electrical stimulation, mapping the speech center exactly, and then overlapping the results obtained in the preoperative MRIs under the control of the navigation method. Moreover, all awake brain surgeries risk having an epileptic attack during surgery. This risk may cause more severe consequences in awake brain tumor surgeries than in anesthetized surgeries.