Before an<unk>  begins for tumor or epilepsy surgery, the patient is given anxiolytic medications. The patient is then positioned in a neurosurgical head restraint that holds the head completely still and given general anesthesia. The anesthesiologist will then use local anesthetics like lidocaine or bupivacaine to numb the skin and bone of the head and neck. The craniotomy begins with a surgeon removing an area of the skull over the tumor and cutting into the meninges, the membranes that protect the brain. Before removing any brain tissue, the patient is<unk> ned and the neurosurgeon creates a cortical map, using a small electrical stimulation device to observe the changes in the patient's condition when an area is stimulated. If an area is stimulated and the patient moves or loses some ability, like speech, the surgeon knows that the area is vital and cannot be removed or cut through to access a tumor. During the procedure, the surgeon, anesthesiologist, and other surgical personnel speak to the patient, and there is a technician constantly assessing the patient's ability to name objects, for example, or report any abnormal sensations. There are two variations on the technique:<unk> -asleep-awake (AAA), and monitored anesthetic care (MAC), also called conscious sedation. In an AAA surgery, the patient is only<unk>  during the cortical mapping; whereas in an MAC surgery the patient is<unk>  the entire time. The procedure for deep brain stimulation placement is similar, though instead of skull being removed, a burr hole is drilled for the electrodes instead and the MAC surgery is more common.
Awake craniotomy
Craniotomy
Suboccipital puncture
Decompressive craniectomy
Cranioplasty
Minimal-access cranial suspension
Frontal sinus trephination
Astragalectomy