Washington University neurosurgeons at Barnes-Jewish Hospital use
sophisticated techniques for brain mapping to advance awake craniotomy
procedures – the gold standard of surgery to treat certain dangerous
brain tumors. Approximately 15 patients a year undergo this surgery at
Barnes-Jewish, and these brain mapping techniques – including techniques
developed at Washington University – coupled with intraoperative MRI
technology, can give patients better outcomes and preserve more healthy
brain tissue.
Awake Craniotomy Procedure
In an awake craniotomy surgery, the patient is sedated while the
surgeon opens the skull to expose the brain. The patient is then brought
out of sedation to full consciousness. The patient can interact with
the doctor during the procedure. This interaction is the most reliable
way to ensure that the doctor does not damage healthy tissue while
removing as much of the tumor as possible. The doctor will ask the
patient to answer questions and perform simple tasks, to make sure their
motor and speech function remains intact.
During the surgery, the patient will feel no pain, as the brain itself does not have pain receptors.
Awake craniotomies are performed in the intraoperative MRI
suite that allows neurosurgeons to make real-time MRI images during the
procedure. This lets surgeons get a high resolution picture of the brain
as another way to insure that the maximum amount of tumor is safely
removed.
In addition, doctors at Washington University and Barnes-Jewish use
several techniques to map the brain before and during the surgery. These
techniques help neurosurgeons pinpoint areas of the brain that control
different behaviors. These techniques include using a grid of sensors
laid directly on the surface of the brain to detect electrical signals. A
computer program collects the electrical data and generates a digital
map to guide the surgeons to the tumor tissue with greater accuracy.
Using brain mapping with awake craniotomy, “we are able to accomplish a
more aggressive surgery in sensitive areas while preserving function,”
says Eric Leuthardt, MD, Washington University neurosurgeon at
Barnes-Jewish. Dr. Leuthardt is nationally known for advancing brain
mapping techniques.
What to Expect
For patients with difficult brain tumors in areas near speech or
motor centers in the brain, awake craniotomy offers better outcomes and
preserves more functionality than many other treatments. These patients
may have a shorter recovery time in the hospital.
For a referral to a Washington University neurologist or neurosurgeon at Barnes-Jewish Hospital, call
.