Operating environment for awake brain surgery - Choice of tests

Area of Science:

• Neurosurgery
• Cognitive Neuroscience

Background:

• Awake brain surgery requires identifying eloquent brain areas and critical functions to preserve.
• Preoperative patient collaboration and intraoperative neuropsychological testing are key.

Purpose of the Study:

• To explore the prerequisites and essential components for successful awake brain surgery.
• To highlight the importance of multidisciplinary collaboration and specialized personnel.

Main Methods:

• Preoperative determination of functions to preserve through patient collaboration and neuropsychological tests.
• Selection of relevant intraoperative tests, with no universal consensus for high-level cognitive functions.
• Emphasis on multidisciplinary decision-making involving neurosurgeons, neurologists, speech therapists, and neuropsychologists.

Main Results:

• A wide array of surgical tools and technologies exist for awake brain surgery, but none are universally mandatory.
• The critical factor is the transition from identifying eloquent areas to preserving brain functions, necessitating skilled multidisciplinary human resources.
• Success is more probable in centers specializing in functional oncological neurosurgery.

Conclusions:

• Highly skilled multidisciplinary teams are more crucial than specific technologies for preserving brain functions during awake surgery.
• Specialized centers focusing on functional oncological neurosurgery are better equipped to achieve optimal outcomes.
• Individualized selection of intraoperative tests, based on preoperative multidisciplinary decisions, is vital.