Awake image-guided brain surgery

What the best neurosurgical advance in the last decade entails

Imagine waking up in the middle of brain surgery. At the University of Michigan, that’s exactly what we want you to do. We call this procedure awake image-guided brain surgery. It is one of the most monumental changes in neurosurgery in the last decade.

Awake brain surgery has been around for many years, but combining this technique with sophisticated new “GPS” technologies has allowed us to more effectively treat some neurological conditions, such as brain tumors or epileptic seizures. These technologies involve incorporating medical images, like MRI and CT scans, into a computerized navigation device that can guide surgeons during an operation to specific areas in the brain only visible on those medical images.

Awake image-guided brain surgery enables us to pinpoint the exact location of tumors or seizure-producing areas and to test your neurological responses so that we can operate with greater safety and better efficacy. We perform surgery while you are awake to more effectively treat some neurological conditions, like brain tumors and epilepsy.

It allows us to perform surgery without affecting nearby portions of the brain that are necessary for vital functions.

How awake image-guided brain surgery works

You are deeply sedated by the neuroanesthesiologist for most of the uncomfortable parts of the procedure, but there are times that you are awake and able to cooperate with neurologic testing. We use different types of testing in the operating room depending on the location in the brain being operated on.

In some cases, we test motor strength and dexterity, and in some cases we test language functions with the help of our speech and language pathologist.

These tests show us the areas in the brain that are involved in those types of functions, and provide crucial information about our ability to safely remove an area of the brain that is causing seizures or, in some cases, a brain tumor.

Guidelines as you prepare for your procedure

Having the opportunity to meet your neurosurgical team ahead of surgery is a huge plus. Ask if you’ll have the opportunity to meet with your surgeon, neurologist, neuroanesthesiologist, speech language pathologist and operating room nurse well ahead of time.

Consider asking questions like:

  • How many procedures such as this have the team performed?
  • Will your care team be with you throughout the whole process?
  • Will your companions be updated as to your medical status while you are in surgery?
  • Will your recovery nurse be with you as you regain consciousness?
  • How soon after surgery will you be admitted to your hospital unit?

Prior to your surgery date and arrival at the hospital:

  • Be sure to follow the directions that your doctors and nurses gave you.
  • Call the designated member of your surgical team with any concerns or medical conditions that arise.

Take the next step:

Oren Sagher, M.D.,Oren Sagher_glasses is a neurosurgeon and professor of neurological surgery at the University of Michigan Health System. His research interests include stroke, spinal cord stimulation, brain tumors, nanoparticles and epilepsy.





Neurosciences logoThe University of Michigan’s multidisciplinary neuroscience team is made up of more than 70 nationally recognized neurologists, neuroanesthesiologists and neurosurgeons. Leading the way in brain, spine and nervous system care for close to 100 years, patients have access to services that can be found at only a handful of places as well as innovative treatments with the latest research. Neurology and Neurosurgery at the University of Michigan Health System have been recognized by U.S. News & World Report numerous times for excellence in patient care.