Keeping patients conscious during brain surgery to treat tumors or epilepsy can help the surgeon avoid removing areas of the brain needed to communicate with language.
In the past, language processing was thought to be associated with two areas of the brain, according to Dr. Daniel Yoshor, assistant professor of neurosurgery at Baylor College of Medicine in Houston. But now scientists know the ability to use language is spread out in the brain, typically on multiple nodes throughout the side of the brain dominant for language.
"And the locations vary significantly from patient to patient," Yoshor said.
In preparation for the awake craniotomy, the patient is put to sleep with intravenous sedatives while the scale and outer lining of the brain are numbed directly with anesthetic medication. After the scalp and skull have been opened, the anesthesiologist allows the patient to regain consciousness to participate in language testing that helps the neurosurgeon determine which parts of the person's brain process language.