Awake Craniotomy in Neurosurgery: A Bibliometric Analysis of the Top 100 Most-Cited Articles and Review of Technological Advancements

Awake craniotomy (AC) is a critical neurosurgical technique for maximizing tumor resection in eloquent brain regions while preserving essential neurological functions like speech and motor control. Despite its widespread adoption, no prior bibliometric analysis has evaluated the most influential research in this field. This study analyzed the top 100 most-cited articles on AC to identify key trends, influential works, and authorship demographics. A systematic search of the Web of Science Core Collection on September 17, 2024, yielded 718 publications, with the top 100 ranked by citation count. Analysis revealed a surge in AC research after 2013, peaking in 2021, with the Journal of Neurosurgery contributing significantly (49 articles; 2,611 citations). Themes included functional mapping, anesthetic techniques, and patient outcomes, with technological advancements such as intraoperative MRI and virtual reality enhancing surgical precision. Authorship analysis highlighted a gender disparity, with male authors occupying 77% of first authorship and 88% of senior roles. These findings underscore AC's evolution, foundational studies, and ongoing advancements while emphasizing the need for greater diversity and inclusion in the field.