Awake Craniotomy in Patients With Language Deficits: A Retrospective Cohort Study in 48 Patients

Suzanne L Hartung; Irene M C Huenges Wajer; Martine J E van Zandvoort; Pierre A Robe

doi:10.1227/ons.0000000000001806

Awake Craniotomy in Patients With Language Deficits: A Retrospective Cohort Study in 48 Patients

Suzanne L Hartung
, Irene M C Huenges Wajer
, Martine J E van Zandvoort
, Pierre A Robe

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

BACKGROUND AND OBJECTIVES: This retrospective cohort study reviewed the feasibility and applicability of awake surgery for glioma in patients with clinically relevant preoperative language deficits, specifically focusing on intraoperative language monitoring and its impact on postoperative language outcomes.

METHODS: Group and individual analyses were conducted to compare preoperative and postoperative language deficits. In addition, an overview of intraoperative tests was provided, and an evaluation of the monitoring process was performed.

RESULTS: In 100% of patients with significant (z score ≤ -1 SD) preoperative language deficits (N = 48), language tasks could be performed during awake surgery. In 90% of these cases, functional boundaries for language function were found during surgery.

CONCLUSION: This study confirms the feasibility and applicability of monitoring language functions during awake brain surgery when preoperative language deficits are present. Both low-grade and high-grade glioma patients show an overall stable performance on a language comprehension test and an improved performance on a language production test 3 to 6 months after surgery and, therefore, seemed to benefit from cognitive monitoring.

Original language	English
Pages (from-to)	285-292
Journal	Operative neurosurgery (Hagerstown, Md.)
Volume	31
Early online date	22 Oct 2025
DOIs	https://doi.org/10.1227/ons.0000000000001806
Publication status	Published - 1 Aug 2026

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title = "Awake Craniotomy in Patients With Language Deficits: A Retrospective Cohort Study in 48 Patients",

abstract = "BACKGROUND AND OBJECTIVES: This retrospective cohort study reviewed the feasibility and applicability of awake surgery for glioma in patients with clinically relevant preoperative language deficits, specifically focusing on intraoperative language monitoring and its impact on postoperative language outcomes.METHODS: Group and individual analyses were conducted to compare preoperative and postoperative language deficits. In addition, an overview of intraoperative tests was provided, and an evaluation of the monitoring process was performed.RESULTS: In 100\% of patients with significant (z score ≤ -1 SD) preoperative language deficits (N = 48), language tasks could be performed during awake surgery. In 90\% of these cases, functional boundaries for language function were found during surgery.CONCLUSION: This study confirms the feasibility and applicability of monitoring language functions during awake brain surgery when preoperative language deficits are present. Both low-grade and high-grade glioma patients show an overall stable performance on a language comprehension test and an improved performance on a language production test 3 to 6 months after surgery and, therefore, seemed to benefit from cognitive monitoring.",

author = "Hartung, \{Suzanne L\} and \{Huenges Wajer\}, \{Irene M C\} and \{van Zandvoort\}, \{Martine J E\} and Robe, \{Pierre A\}",

note = "Copyright {\textcopyright} 2025 The Author(s). Published by Wolters Kluwer Health, Inc on behalf of Congress of Neurological Surgeons.",

year = "2026",

month = aug,

day = "1",

doi = "10.1227/ons.0000000000001806",

language = "English",

volume = "31",

pages = "285--292",

journal = "Operative neurosurgery (Hagerstown, Md.)",

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T1 - Awake Craniotomy in Patients With Language Deficits

T2 - A Retrospective Cohort Study in 48 Patients

AU - Hartung, Suzanne L

AU - Huenges Wajer, Irene M C

AU - van Zandvoort, Martine J E

AU - Robe, Pierre A

PY - 2026/8/1

Y1 - 2026/8/1

N2 - BACKGROUND AND OBJECTIVES: This retrospective cohort study reviewed the feasibility and applicability of awake surgery for glioma in patients with clinically relevant preoperative language deficits, specifically focusing on intraoperative language monitoring and its impact on postoperative language outcomes.METHODS: Group and individual analyses were conducted to compare preoperative and postoperative language deficits. In addition, an overview of intraoperative tests was provided, and an evaluation of the monitoring process was performed.RESULTS: In 100% of patients with significant (z score ≤ -1 SD) preoperative language deficits (N = 48), language tasks could be performed during awake surgery. In 90% of these cases, functional boundaries for language function were found during surgery.CONCLUSION: This study confirms the feasibility and applicability of monitoring language functions during awake brain surgery when preoperative language deficits are present. Both low-grade and high-grade glioma patients show an overall stable performance on a language comprehension test and an improved performance on a language production test 3 to 6 months after surgery and, therefore, seemed to benefit from cognitive monitoring.

AB - BACKGROUND AND OBJECTIVES: This retrospective cohort study reviewed the feasibility and applicability of awake surgery for glioma in patients with clinically relevant preoperative language deficits, specifically focusing on intraoperative language monitoring and its impact on postoperative language outcomes.METHODS: Group and individual analyses were conducted to compare preoperative and postoperative language deficits. In addition, an overview of intraoperative tests was provided, and an evaluation of the monitoring process was performed.RESULTS: In 100% of patients with significant (z score ≤ -1 SD) preoperative language deficits (N = 48), language tasks could be performed during awake surgery. In 90% of these cases, functional boundaries for language function were found during surgery.CONCLUSION: This study confirms the feasibility and applicability of monitoring language functions during awake brain surgery when preoperative language deficits are present. Both low-grade and high-grade glioma patients show an overall stable performance on a language comprehension test and an improved performance on a language production test 3 to 6 months after surgery and, therefore, seemed to benefit from cognitive monitoring.

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DO - 10.1227/ons.0000000000001806

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SN - 2332-4252

VL - 31

SP - 285

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JO - Operative neurosurgery (Hagerstown, Md.)

JF - Operative neurosurgery (Hagerstown, Md.)

ER -

Awake Craniotomy in Patients With Language Deficits: A Retrospective Cohort Study in 48 Patients

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