• Julius July, Pirjo Manninen, Jacob Lai, Zhenhai Yao, and Mark Bernstein.
• Division of Neurosurgery, University Health Network, Toronto Western Hospital, Toronto, Ontario, Canada M5T 2S8.
• Surg Neurol. 2009 May 1;71(5):621-4; discussion 624-5.

AbstractIn ancient times, awake craniotomy was used for trepanation to treat seizures and remove a variety of morbid conditions or even to permit the escape of evil air. In modern times, this technique was initially used for removal of epileptic foci with simultaneous application of brain mapping with electrical current. Further developments brought this technique into use for resection of tumors involving functional cortex. Recently, awake craniotomy has been described as an approach for removal of supratentorial tumors nonselectively, regardless of the involvement of eloquent cortex. It has been used in North America since the 1980s, then Europe, and recently has spread into Asia. Its spread to Asia could have significant impact based on the large population of patients and the low resource utilization associated with awake craniotomy.

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