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Awake Craniotomies


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A craniotomy is an intricate neurological procedure performed by opening the skull, performing the needed surgery, and closing the skull by securing the bone into its original position. An awake craniotomy, or awake brain surgery, is a minimally invasive surgery where the patient is awake during the procedure. Awake craniotomies require less bone removal and limit the injury done to surrounding brain tissue, significantly reducing the impact on your quality of life.

ViewSite Brain Access System
Illustration depicting transsulcal insertion of ViewSite Brain Access System tubular retractor. The retractor is inserted transsulcally to minimize cortical trauma. The rounded shape of the retractor is thought to spread white matter tracts rather than transecting them, thus preserving them to the maximal extent possible.

Expert neurosurgeons at the University of Miami Health System use awake craniotomies to remove complex brain tumors while working to preserve speech and language function. We are one of only a handful of neurosurgeons in the United States who perform awake craniotomies.

What is a Complex Brain Tumor?

A complex brain tumor is an abnormal growth in the brain that is close to critical areas, such as near those areas of that brain that control speech and movement. Removing only the tumor — while preserving precious brain tissue and bodily function — is a complicated procedure that can only be successfully performed by expert neurosurgeons.

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Who is a Candidate?

If you have a complex brain tumor, your neurosurgeon may recommend you undergo an awake craniotomy to help preserve your speech and language abilities.

What to Expect

During an awake craniotomy, our neurosurgeons and neurologists use advanced brain-mapping techniques to identify and avoid injury to the sites of language, motor, and sensory function. We do this by using electrical currents to stimulate specific areas of the brain, and then using imaging to determine if that electrical current is impacting the brain area. For example, when a tumor is near critical speech areas of the brain, it is important to determine the exact location of these speech-related areas to avoid affecting them. 

An awake craniotomy is performed on an inpatient basis in the hospital, meaning that you’ll expect to spend the night after your procedure. You will be under full anesthesia (asleep) when the procedure begins. Your surgeon will make an incision in your head near the area of skull they need to remove temporarily to reach the tumor. 

Once your neurosurgeon reaches the area of your brain where the tumor is, the sedation will be slowly lifted to allow you to be “awake” and communicate with your surgical team. Our specialists use imaging techniques – such as magnetic resonance imaging (MRI) or computerized tomography (CT) scans – to locate the exact areas of the brain used for language, muscle skills, and sensation. 

Your neurosurgeon will ask you to talk, move, and follow commands. If the electric stimulation affects your ability to perform any of these tasks, then the surgeon knows to avoid the area and leave it intact because it is not affected by the tumor. Once the tumor is removed, you will be sedated again while the surgeon finishes the operation. Your skull will be placed back in position, and the incision will be closed with stitches and covered with a sterile dressing.

After the procedure, you will be monitored closely for 24 to 48 hours. You should be able to eat, drink, and move around – with help – soon after the procedure. You will likely return home from the hospital a few days after the awake craniotomy, and then see your neurosurgeon for a post-operative visit about a week later.

Accepted Insurances

Note: Health plans that are currently contracted with UHealth are listed below. However, please check with your insurance provider to verify that UHealth is part of your provider network.

  • Aetna WC
  • Aetna Affiliates/Signature Adm (ASA)
  • Aetna Behavioral Health
  • Aetna Elect Choice (EPO)
  • Aetna Florida Healthy Kids
  • Aetna HMO
  • Aetna Medicaid HMO
  • Aetna Medicare HMO
  • Aetna Medicare PPO
  • Aetna POS
  • Aetna PPO
  • Aetna UM Employee HMO 1
  • Aetna UM Employee HMO 2
  • Aetna UM Employee POS HRA
  • Aetna/Coventry Institutes of Excellence (IOE)
  • Amerigroup Florida Healthy Kids
  • Amerigroup Medicaid HMO
  • Argus Vision
  • AvMed Choice
  • AvMed HMO/POS
  • AvMed MDC and JHS Groups
  • AvMed Medicare HMO
  • AXIS
  • BCBS Blue Options Network Blue PPO
  • BCBS BlueCare HealthOptions HMO
  • BCBS BlueChoice PPC/PPO
  • BCBS Miami Dade Blue PPO Limited Benefits Plan
  • BCBS of Florida (All products except "SELECT" Plans)
  • BCBS of Florida (Commercial plans exclude HIX Select)
  • BCBS Traditional PHS/PPO
  • Beacon Health (ValueOption)
  • Beech Street PPO
  • Broward Health Medical Center
  • CarePlus Medicare HMO
  • Catholic Hospice
  • CCP/CMS Title XIX (Medicaid Enrolled in South Florida)
  • CCP/CMS Title XXI (Non Medicaid Enrolled in South Florida)
  • CCP/MMA (Broward County residents)
  • Charlotte County Sheriffs Office PPO
  • Cigna Affiliates
  • Cigna Behavioral Health
  • Cigna Dental HMO/PPO
  • Cigna EPO
  • Cigna HMO
  • Cigna Life Source (Intracorp is part of Cigna Lifesource)
  • Cigna MDCPS Jackson Sr. High
  • Cigna POS
  • Cigna PPO
  • Cigna Shared Administration
  • Clear Health Alliance SNP Medicaid HMO
  • Concordia Behavioral Health
  • CorVel WC
  • Coventry First Health WC
  • Coventry Health Care of Florida (HIP) HMO/POS
  • Coventry Health Care of Florida (HIP) PPO
  • Coventry Health Plan of Florida (Foundation) HMO
  • Coventry Health Plan of Florida (Foundation) POS
  • Coventry National PPO
  • Coventry Summit Medicare HMO
  • Coventry Vista Medicare HMO
  • Coventry First Health PPO
  • Delta Dental PPO
  • DentaQuest (ADI)
  • Dimension WC
  • Dimension Plus PPO
  • Doctor's Healthcare Plan
  • EQUIAN (Health Systems International)
  • Europe Assistance/Global Corporate Solutions (Care Management Network)
  • eyeQuest
  • Florida Community Care (FCC)
  • Florida Healthcare Plan (Affiliate of BCBSFL)
  • Florida PACE (FPC)
  • Freedom Health Medicaid HMO
  • Freedom Health Medicare HMO
  • Gallagher Bassett WC (MDCPS & FCSRMC)
  • Global Excel Mgt PPO
  • Great West (Cigna) HMO/POS
  • Guardian Life PPO
  • HAA Preferred Partners
  • Health First Health HMO/POS
  • Health First Health Medicare HMO
  • Health First Health PPO
  • Health Net Veterans Choice HMO
  • Heritage Summit Healthcare WC
  • Humana Behavioral Health (LifeSynch)
  • Humana Dental/CompBenefits/OHS
  • Humana EPO
  • Humana HMO
  • Humana Medicaid HMO
  • Humana Medicare HMO
  • Humana National Transplant
  • Humana PPO
  • Humana Premier
  • iCare Health Solutions
  • Interlink Health Services
  • International Kids Fund (IKF)
  • League Medical Concepts Federal Inmates
  • Life Trac
  • Magellan Behavioral Health
  • Magellan Complete Care SNP Medicaid HMO
  • MDAbroad
  • Medica Medicare HMO
  • Medical Development In't (MDI)-Federal Inmates
  • Medicus
  • Metlife Dental PPO
  • MHNet Behavioral Network (MHNet)
  • Molina
  • Molina Market Place
  • Molina Medicaid HMO
  • Molina Medicare HMO
  • Morgan White International
  • MultiPlan PPO
  • Naphcare (Federal Prisoners)
  • National Healthcare Solutions Inc.
  • Neighborhood HealthPlan HMO/POS
  • Neighborhood HealthPlan PPO
  • North Broward Hospital District PPO
  • Olympus Managed Healthcare
  • Optum
  • Positive Healthcare SNP Medicaid HMO
  • Positive Healthcare SNP Medicare HMO
  • Prestige Health Choice Medicaid HMO
  • Prime Health Services WC
  • Quality Health Management
  • Religious Order of Jehovah's Witnesses PPO
  • Rockport Healthcare Group WC
  • Royal Caribbean Cruises PPO
  • Sanus Health Corporation
  • Seasons Hospice
  • Simply Healthcare Medicaid HMO
  • Solstice Dental HMO/PPO
  • Start Healthcare Network
  • Sunshine
  • Sunshine AMBETTER
  • Sunshine Healthy Kids HMO
  • Sunshine Medicaid HMO
  • Sunshine Medicare HMO
  • Tricare South Prime HMO
  • Tricare South Standard PPO
  • United Behavioral Health (UBH)
  • UnitedHealthcare Affiliates
  • UnitedHealthcare Healthy Kids HMO
  • UnitedHealthcare HMO/POS
  • UnitedHealthcare Medicaid HMO
  • UnitedHealthcare Medicare Nursing Home Plan
  • UnitedHealthcare PPO
  • University of Miami Athletic Dept PPO
  • VUMI
  • Wellcare/Staywell Healthy Kids HMO
  • Wellcare/Staywell Medicaid HMO
  • Wexford Health State Inmates
  • Worldwide Managed Care