Awake craniotomy

The resection of an intracranial brain tumour is challenging for anaesthetic and neurosurgical management as well as for the patient. The possibilities of microsurgery, the use of ultrasound for intraoperative imaging, neuronavigation, fluorescent dye and establishment of neuromonitoring represent an impor- tant advance. A further crucial step to discriminate the functional brain tissue from the brain tumour is the testing and monitoring of an awake and compliant patient during surgical resection. This allows optimising the surgical results as well as the patient safety. To improve patient cooperation, an experienced and qualified team of anaesthesiology experts is needed. There are two approaches: "asleep - awake - asleep" and "awake - awake - awake". This article aims to present an overview of a craniotomy in the "awake - awake - awake"-proce- dure including the choice of patients, the necessary equipment, the manage- ment of complications and postoperative care.