Brain surgery, or craniotomy, is typically performed under general anesthesia, meaning the patient is unconscious throughout the procedure. But did you know that there is a type of brain surgery that is done while the patient is awake?
Awake brain surgery, or conscious craniotomy, is a surgical procedure performed while the patient is conscious. During the operation, the patient remains responsive and can answer questions asked by the medical team.
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What is Awake Brain Surgery?
Awake brain surgery is a neurosurgical procedure conducted while the patient is awake and alert. This approach is typically used to treat certain neurological conditions, such as brain tumors or epileptic seizures.
If the tumor or seizure focus is located near areas of the brain that control vision, movement, or speech, surgery may need to be performed while the patient is conscious. This allows the surgeon to monitor the patient’s brain activity and responses in real time.
The patient’s responses help guide the surgeon to operate only in the necessary areas while minimizing the risk of damaging vital brain functions.
Purpose of Awake Brain Surgery
If the brain tumor or seizure focus needs to be surgically removed, the surgeon must ensure the area is not too close to brain regions responsible for language, speech, or motor function.
Accurately identifying these critical regions before surgery is often challenging. Awake brain surgery allows surgeons to precisely map and avoid these areas during the procedure, significantly reducing the risk of neurological complications.
Awake Brain Surgery Procedure
During the procedure, the anesthesiologist will administer sedation to make the patient sleep during certain parts of the surgery. The neurosurgeon will also apply local anesthesia to the scalp to ensure the patient’s comfort.
The patient’s head is securely positioned to prevent movement and allow for precise surgery. Some hair will be shaved, and the surgeon will open a small part of the skull to access the brain.
At the beginning and end of the procedure, the patient will be asleep while the skull is opened and closed. In the middle of the operation, anesthesia is paused to allow the patient to wake up and interact with the medical team.
If the tumor or seizure source is near critical areas, the surgeon will perform brain mapping to identify regions responsible for key functions such as vision, movement, and speech—even deep brain structures can be mapped during surgery.
This mapping helps avoid damage to essential brain areas, preserving vital functions. With the aid of 3D computer imaging, surgeons can safely remove as much of the tumor or seizure focus as possible while minimizing risks.
During the operation, the medical team may ask the patient to answer questions, recognize images or words on a screen, or perform simple tasks like counting or moving fingers. These responses help identify functional areas of the brain that need to be protected.
The team also uses detailed 3D brain imaging—including intraoperative MRI and computer-assisted brain surgery tools—to guide safe and optimal removal of brain tissue.
Throughout the procedure, the anesthesiologist and surgical team continuously monitor the patient’s body and brain functions and issue alerts if the surgery begins to affect critical functions.
Awake Brain Surgery at Mandaya Royal Puri Hospital Led by a Leading Neurosurgeon in Indonesia
Awake brain surgery at Mandaya Royal Puri Hospital is performed by one of Indonesia’s top neurosurgeons: Dr. dr. Mardjono Tjahjadi, Sp.BS, Subsp. N-Vas, F. N-Onk, PhD, FICS, IFAANS — also known as Dr. Joy. The procedure involves a multidisciplinary medical team, including neurologists and anesthesiologists.
Mandaya Royal Puri Hospital is also equipped with advanced facilities to support awake brain surgery. One of them is Intraoperative Neuromonitoring (IONM)—a sophisticated tool that monitors the patient’s nervous system during the operation to prevent nerve damage while removing brain tumors.
Dr. Joy’s Consultation Schedule at Mandaya Royal Puri Hospital
- Monday: By appointment
- Tuesday: 14.00 – 17.00 WIB
- Wednesday: By appointment
- Thursday: 08.00 – 12.00 WIB
- Friday: 14.00 – 17.00 WIB
- Saturday: 08.00 – 12.00 WIB
Book a Consultation with Dr. Joy for Awake Brain Surgery
If you would like to consult Dr. Joy about brain tumors or awake brain surgery, don’t hesitate to visit Mandaya Royal Puri Hospital.
To make your visit easier, use the WhatsApp Chat, Book Appointment feature, or download the Care Dokter App via Google Play or the App Store to check queue numbers, schedule visits, and access complete hospital information.
