Awake Brain Surgery with Speech & Motor Mapping
When a tumor sits next to the brain areas that control speech, movement or vision, the safest way to remove it is with the patient awake for the critical part of the operation. Gentle electrical stimulation identifies the essential areas in real time, and the tumor is removed around them while a neuropsychologist talks with you, has you name pictures, or move your hand.
Patients are surprised by how calm the experience is. Sedation is used for the opening and closing; the brain itself has no pain receptors. Awake mapping lets Dr. Daggubati remove more tumor with less risk of a permanent deficit.
Who it is for
- Gliomas or metastases in or near language, motor or sensory cortex
- Tumors near the visual pathways
- Patients who can cooperate with testing (most adults)
Why we use it
- More complete tumor removal
- Lower risk of permanent speech or motor deficit
- Real-time confirmation of function
- Shorter hospital stay
How the procedure is done
- Pre-operative functional MRI and tractography map the pathways.
- Sedation and scalp block for the opening; you are awakened once the brain is exposed.
- Stimulation mapping identifies critical areas while you perform simple tasks.
- The tumor is removed with continuous monitoring of your function.
- Sedation resumes for closure.
Recovery
Similar to other craniotomies; temporary word-finding difficulty or weakness in the days after surgery is common and usually resolves.
Risks, stated plainly
Seizure during mapping (managed immediately), temporary or rarely permanent deficit, plus general craniotomy risks. Dr. Daggubati reviews the specific risks for your situation in person before any decision is made.
Preparing for this surgery
Dr. Daggubati has written detailed guides for this procedure covering medications to stop, prehabilitation, the day of surgery, and a week-by-week recovery timeline.
Common questions
Will I feel pain or remember it?
The scalp is numbed and the brain has no pain fibers. Most patients recall a calm conversation and little else.