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First “Awake” Brain Surgery at Houston VA

The Houston VA surgery team performs first
The Houston VA surgery team performs first "awake" brain surgery at Houston VA.

As a neurosurgeon at the Houston VA Medical Center and Baylor College of Medicine, Dr. Ali Jalali enjoys getting to know his Veteran patients and learning about their military service.  

This week, Jalali and a team of VA doctors got to hear a Marine Corps Veteran talk about his service in the Persian Gulf while they performed an awake craniotomy to remove his brain tumor.  The Veteran shared stories of his multiple tours to Afghanistan, while VA surgeons removed his brain tumor during a complex and painstaking operation.  This first awake brain tumor surgery at the Michael E. DeBakey VA Medical Center was a resounding success, with the Veteran being discharged and home with his family just in time for the Thanksgiving holiday.

“Keeping the Veteran awake during this complex surgery allowed our medical team to continuously monitor and protect his critical brain functions while maximizing the extent of tumor removal,” said Jalali.  “Our team performed flawlessly and it was particularly interesting to hear the Veteran talk about his deployments as the surgery progressed.” 

Brain tumors are often located in regions of the brain that control specific functions, such as movement or speech.  During an awake craniotomy, a neurosurgeon uses sophisticated mapping technology to physically map out parts of the brain that control speech and motor functions prior to tumor removal.  The Houston VA team in the surgery included neurosurgeons, anesthesiologists, neurologists, and neuropsychologists, as well as highly experienced nurses and operating room staff.

“In this type of surgery, the anesthesiologist initially puts the patient to sleep and then wakes him or her up once the brain surface is exposed,” Jalali said.  “The patient gives us real-time feedback during the surgery that guides us through the process.”

According to the American Cancer Society, nearly 25,000 people are diagnosed with this type of brain tumor every year, making it a relatively common cancer.   Dr. Jalali described the value of performing awake surgeries to remove the smaller fraction of tumors that are located in critical parts of the brain. 

“Pretty much every part of the brain has a function, so we try and remove these tumors, or as much of them as possible, while preserving people’s function and their quality of life,” he said. “Certain complex functions in critical brain areas are best mapped and protected while the patient is awake.”

Although the results of the surgery can save or prolong lives, the thought of being awake during surgery can be intimidating for some patients. 

“I believe Veterans are inherently courageous and welcoming of challenging situations, whether helping to defend the country or staying awake during brain surgery to help the surgeon,” Jalali said.  “We are thrilled to bring this highly specialized procedure to our Veterans at the Houston VA.”

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