Craniotomy with the patient awake. Literature review

Abstract

Introduction: awake craniotomy is a neurosurgical procedure in awake patients. It is used to perform electrocorticographic or electrophysiological mapping prior to resection of lesions close to eloquent areas or minor intracranial operations.

Objective: to analyze the scientific evidence available on the execution of craniotomy with the patient awake.

Methods: a review of articles published in the SciELO, PubMed, LILACS databases and in the Google Scholar search engine, between 2019 and 2024, in Spanish and English, was carried out. Keywords present in the descriptors in health sciences in Spanish were used. Of the 60 articles located, 30 publications were selected.

Development: the multidisciplinary team of specialists must be trained in the procedure. All of them must have preferential training in neurosciences, be familiar with the technique, maintain effective communication so that each one fulfills his or her specific functions in the different stages of the intervention, and be aware of the possible complications in order to act accurately and immediately.

Conclusions: awake craniotomy has unquestionable advantages. It also requires a team in which anesthesiologists and neurosurgeons have solid knowledge and technical skills, and the psychologist and neuropsychologist accompany the patient before, during and after the intervention. The safest and most effective strategy for its success is the correct application of the accelerated postoperative recovery protocol. This literature review contributes to disseminating among specialists a surgical technique whose complications are few and avoidable