**6.1 Cognitive follow-up**

Apart from the regular clinical-radiological assessment after the surgery, a neuropsychological evaluation is particularly important in patients who have been operated awake.

Cognitive deficits are one of the most frequent symptoms in patients with brain tumors, mainly in attention, memory, language, and executive functions. These deficits may not only be present before surgery but can also appear after it because of the tumor itself or due to the surgical procedure. Cognitive dysfunction negatively impacts the quality of life of patients and their reincorporation into their daily functioning. Therefore, it is necessary to plan an intervention adapted to the circumstances of each patient.

Neuropsychological rehabilitation combines the application of cognitive intervention strategies and compensatory systems. These targeted strategies reduce emotional problems and promote socio-labor integration. According to scientific evidence, effective intervention methods are those that combine metacognitive and emotional regulation strategies and generalization of their effects on daily life [27, 28]. These interventions combine psychoeducational programs (providing information on cognitive functioning and their consequences in daily life, from both the patients and their families) with direct or compensatory training of the affected functions and environmental strategies (focused on restructuring the patient's environment to meet the new demands of daily activity).
