Brain & Mind Center

Functional and Awake Patient Oncology Surgery Unit

The unit

Precision tumour resection. Real-time functional protection.

The Functional and Awake Brain Surgery Unit at the Publio Cordón Memorial Hospital treats brain tumours located in critical functional areas using high-precision resection techniques designed to preserve speech, movement and other essential functions.

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Dr Roberto García Leal
Head of the unit

Dr Roberto García Leal

Specialist in
  • Microsurgery for cerebral aneurysms and vascular malformations.

  • Functional brain cancer surgery and awake brain surgery.

  • Endoscopic brain surgery and microsurgery for skull base tumours.

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Medical team

Our specialists

Dr Fernando Ruiz Juretschke

Dr Fernando Ruiz Juretschke

Specialist in
  • Minimally invasive surgery for brain tumours.

  • Endoscopic surgery for pituitary adenoma.

  • Cervical microdiscectomy and minimally invasive surgery on the lumbar spine.

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Patient information

Functional and Awake Patient Oncology Surgery Unit

The Functional and Awake Brain Surgery Unit treats patients with brain tumours located in areas responsible for essential functions such as language, movement or memory, where preserving neurological function is a priority. It intervenes in situations where anatomical complexity requires an advanced surgical strategy that allows the lesion to be removed whilst minimising the risk of permanent sequelae.

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Surgical assessment of tumours located in critical functional areas

The unit is aimed at people diagnosed with brain tumours situated in eloquent areas of the brain, where conventional surgery could compromise critical functions. A specialist assessment is particularly recommended in cases of low-grade gliomas, infiltrating tumours or intrinsic lesions close to functional areas.

The decision to perform awake surgery is based on a detailed analysis of the tumour’s location, the patient’s pre-operative neurological status and the balance between oncological radicality and functional preservation.

Indications for surgery whilst the patient is awake Awake surgery is indicated when the lesion affects critical areas and the preservation of function determines the treatment strategy. The decision takes into account anatomical analysis, neurological status and oncological objectives.

Tumour resection with active preservation of essential functions

Each case is assessed on an individual basis, taking into account neurosurgical, oncological and functional criteria. The aim is not merely to resect the tumour, but to do so whilst preserving the abilities that define the patient’s independence.

The unit treats tumours affecting:

  • Language areas

  • Motor or sensory regions

  • Areas related to higher cognitive functions

  • Intrinsic brain lesions and, in selected cases, lesions of the brainstem or spinal cord

The indication for surgery is established once it has been confirmed that the clinical benefit outweighs the functional risk and that the surgical technique allows for adequate tumour control.

The surgical strategy begins with a detailed analysis of each case.
The surgical strategy begins with a detailed analysis of each case.

Functional planning guided by advanced brain mapping

The assessment begins with a specialist consultation and a thorough review of imaging studies, including advanced magnetic resonance imaging and functional tests where necessary.

Detailed pre-operative planning is carried out to identify critical areas of the brain. During the procedure, advanced neurophysiological monitoring and cortical and subcortical mapping techniques are used to identify, in real time, the areas responsible for language, motor function and sensation.

This process makes the surgery a procedure guided by function, not just by anatomy.

Neurological monitoring during surgery During the procedure, neurophysiological monitoring techniques are used to monitor the function of the nervous structures in real time. This helps to fine-tune the tumour resection and reduce the risk of permanent neurological deficits.

Awake surgery in a highly specialised setting

Awake surgery allows for interaction with the patient during specific stages of the procedure, enabling the assessment of essential neurological functions whilst tumour resection is being carried out.

The procedure is carried out in close coordination between neurosurgeons, anaesthetists, neurophysiologists and neuropsychologists. Anaesthesia is tailored to ensure comfort and safety, allowing for periods of active collaboration when necessary.

This strategy enables a more extensive tumour resection to be carried out under greater functional control.

Oncological follow-up and ongoing functional monitoring

The care model integrates oncological planning, high-precision surgery and long-term clinical follow-up. Each case is addressed with sufficient time to explain the diagnosis, treatment options and the detailed procedure, facilitating a clear understanding and an informed decision.

Preparation for surgery whilst the patient is awake includes specific guidance and pre-operative support, addressing any concerns and outlining each stage of the process to reduce uncertainty and build clinical confidence.

Following the procedure, a follow-up plan is established, coordinated with other hospital specialities where necessary. Functional progress is monitored regularly to detect any changes and enable early intervention.

The unit combines advanced neurosurgical expertise, high-precision technology and a clinically humanistic approach that prioritises functional preservation, safety and respect for the patient’s autonomy at every stage of treatment.

Specialist assessment in functional oncological surgery and awake surgery

In the event of a confirmed diagnosis of a brain tumour in a functional area, or where there is a suspicion of involvement in critical areas, the Unit carries out a comprehensive assessment to determine a surgical strategy that strikes a balance between tumour control and neurological preservation.

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