A craniotomy is a neurosurgical operation in which a part of the skull, called a bone flap, is temporarily removed to access the brain underneath. This is a controlled, precise procedure performed by trained neurosurgeons. Once the surgeon has completed the necessary work on the brain, the bone flap is typically replaced and secured with small titanium plates and screws, allowing the skull to heal. This differs from a craniectomy, where the bone flap is not immediately replaced, often to allow the brain room to swell after a major injury or stroke.
An awake craniotomy is a specialised version of the procedure where the patient remains conscious for at least a portion of the operation. While traditional brain surgery is performed under general anaesthesia—which puts the patient into a deep sleep—this technique allows surgeons to monitor brain function in real time through direct interaction. This approach is beneficial when operating near “eloquent” areas of the brain—regions responsible for critical functions such as:
- Speech and Language: The ability to form words and understand others.
- Motor Function: The ability to move specific parts of the body, like arms or legs.
- Sensory Perception: The ability to feel touch or recognise spatial orientation.
By mapping these areas during surgery, neurosurgeons can work to remove tumours or treat other conditions while aiming to minimise the risk of damaging vital functions. The procedure combines local anaesthesia to numb the scalp with carefully controlled sedation, keeping patients comfortable yet alert.
