Awake Craniotomy Procedure: Its Effects on Neurological Morbidity and Recommendations

İŞLEKEL, Sertaç; Akay, Ali

Awake Craniotomy Procedure: Its Effects on Neurological Morbidity and Recommendations

Ali AKAY, (Ege University, Faculty of Medicine, Department of Neurosurgery, Izmir, Turkey)

Sertaç İŞLEKEL (Kent Hospital, Department of Neurosurgery, Izmir, Turkey)

Turkish Neurosurgery

2 0

Yıl: 2018 Cilt: 28 Sayı: 2 Sayfa Aralığı: 186 - 192 Metin Dili: İngilizce İndeks Tarihi: 29-07-2022

Awake Craniotomy Procedure: Its Effects on Neurological Morbidity and Recommendations

Öz:

AIM: To present our experience with the awake craniotomy (AC) method starting from the preoperative period, to report the morbidity and the functional outcomes along with the complications in patients who underwent AC, and to make recommendations for possible problems. MATERIAL and METHODS: This study involved 46 cases- 2 of which were pediatric cases with lesions localized in the functional area - who were operated with the AC method between September 2011 and January 2016 at our clinic. The age range was 12 to 81 years. The average age was 48 years. Both preoperative and postoperative (1, 3, 6 and 12 months) neurological examinations were recorded. RESULTS: Of the 46 patients who had AC surgery in this series, 17 were observed to have neurological deterioration in the intraoperative period. At the month 1 follow-up, 13 of these 17 patients were observed to have full neurological recovery. Moreover, 4 patients that developed hemiplegia were able to mobilize with support at the month 6 follow-up. All patients were observed to have a return of language skills to baseline preoperative function on month 1 follow-up. CONCLUSION: When the results of the AC method were examined, it was observed that persistent postoperative neurological deficit rates were very low in the follow-up period. Based on our practice presented here, it could be concluded that the precise synchrony between the surgeon, the anesthesia team and the patient is required for successful AC and the preservation of language and motor functions

Anahtar Kelime:

Konular: Cerrahi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Akagami R, Napolitano M, Sekhar LN: Patient evaluated outcome after surgery for basal meningiomas. Neurosurgery 50:941-949, 2002
2. Akay A, Ruksen M, Cetin HY, Seval HO, Islekel S: Pediatric awake craniotomy for brain lesion. Pediatr Neurosurg 51(2):103-108, 2015
3. Ard JL Jr, Bekker AY, Doyle WK: Dexmedetomidine in awake craniotomy: A technical note. Surg Neurol 63(2):114-116, 2005
4. Bekar A, Korfali E, Calisir B, Tolunay S: Minimally invasive craniotomy using the Steiner-Lindquist stereotaxic guide. Minim Invas Neurosurg 44(1):13-16, 2001
5. Bernstein M: Outpatient craniotomy for brain tumor: A pilot feasibility study in 46 patients. Can J Neurol Sci 28:120-124, 2001
6. Blanshard HJ, Chung F, Manninen PH, Taylor MD, Bernstein M: Awake craniotomy for removal of intracranial tumor: Considerations for early discharge. Anesth Analg 92(1):89-94, 2001
7. Bohyun S, Hee-Soo K, Jin-Woo P, Hyo-Jin B, Jin-Tae K, Chong Sung K: Anesthetic management with scalp nerve block and propofol/remifentanil infusion during awake craniotomy in an adolescent patient. Korean J Anesthesiol 59 Suppl : 179-182, 2010
8. Brannen JH, Badie B, Moritz CH, Quigley M, Meyerand ME, Haughton VM: Reliability of functional MR imaging with wordgeneration tasks for mapping Broca’s area. Am J Neuroradiol 22(9):1711-1718, 2001
9. Cohen-Gadol AA, Britton JW, Collignon FP, Bates LM, Cascino GD, Meyer FB: Nonlesional central lobule seizures: Use of awake cortical mapping and subdural grid monitoring for resection of seizure focus. J Neurosurg 98(6):1255-1262, 2003
10. Conte V, Magni L, Songa V, Tomaselli P, Ghisoni L, Magnoni S, Bello L, Stocchetti N: Analysis of propofol/remifentanil infusion protocol for tumor surgery with intraoperative brain mapping. J Neurosurg Anesthesiol 22(2):119-127, 2010
11. Costello TG, Cormack JR: Anaesthesia for awake craniotomy: A modern approach. J Clin Neurosci 11(1):16-19, 2004
12. Costello TG, Cormack JR, Mather LE, LaFerlita B, Murphy MA, Harris K: Plasma levobu-pivacaine concentrations following scalp block in patients undergoing awake craniotomy. Br J Anaesth 94(6):848-851, 2005
13. Danks RA, Rogers M, Aglio LS, Gugino LD, Black PM: Patient tolerance of craniotomy performed with the patient under local anesthesia and monitored conscious sedation. Neurosurgery 42: 28–36, 1998
14. Haglund MM, Berger MS, Shamseldin M, Lettich E, Ojemann GA: Cortical localization of temporal lobe language sites in patients with gliomas. Neurosurgery 34(4):567-576, 1994
15. Herrick IA, Craen RA, Gelb AW, Miller LA, Kubu CS, Girvin JP, Parrent AG, Eliasziw M, Kirkby J: Propofol sedation during awake craniotomy for seizures: Patient-controlled administration versus neurolept analgesia. Anesth Analg (84): 1285-1291, 1997
16. Jaaskelainen J, Randell T: Awake craniotomy in glioma surgery. Acta Neurochir 88 Suppl:31-35, 2003
17. Jones H, Smith M: Awake craniotomy. Continuing education in anaesthesia. Critical Care & Pain 4(6):189-192, 2004
18. Keifer JC, Dentchev D, Little K, Warner DS, Friedman AH, Borel CO: A retrospective analysis of a remifentanil/propofol general anesthetic for craniotomy before awake functional brain mapping. Anesth Analg 101(2):502-508, 2005
19. Keles GE, Lundin DA, Lamborn KR, Chang EF, Ojemann G, Berger MS: Intraoperative subcortical stimulation mapping for hemispherical perirolandic gliomas located within or adjacent to the descending motor pathways: Evaluation of morbidity and assessment of functional outcome in 294 patients. J Neurosurg 100:369–375, 2004
20. Larkin M: Neurosurgeons wake up to awake-brain surgery. Lancet 353:1772, 1999
21. Mack PF, Perrine K, Kobylarz E, Schwartz TH, Lien CA: Dexmedetomidine and neurocognitive testing in awake craniotomy. J Neurosurg Anesthesiol 16(1):20-25, 2004
22. Maldaun MV, Khawja SN, Levine NB, Rao G, Lang FF, Weinberg JS, Tummala S, Cowles CE, Ferson D, Nguyen AT, Sawaya R, Suki D, Prabhu SS: Awake craniotomy for gliomas in a high-field intraoperative magnetic resonance imaging suite: Analysis of 42 cases. J Neurosurg 8:1–8, 2014
23. Manninen PH, Tan TK: Postoperative nausea and vomiting after craniotomy for tumor surgery: A comparison between awake craniotomy and general anesthesia. J Clin Anesth 14(4):279-283, 2002
24. McDougall RJ, Rosenfeld JV, Wrennall JA, Harvey AS: Awake craniotomy in an adolescent. Anaesth Intensive Care. 29(4):423-425, 2001
25. Meyer FB, Bates LM, Goerss SJ, Friedman JA, Windschitl WL, Duffy JR, Perkins WJ, O’Neill BP: Awake craniotomy for aggressive resection of primary gliomas located in eloquent brain. Mayo Clin Proc 76:677-687, 2001
26. Paldor I, Drummond KJ, Awad M, Sufaro YZ, Kaye AH: Is a wake-up call in order? Review of the evidence for awake craniotomy. J Clin Neurosci 23:1-7, 2016
27. Sarang A, Dinsmore J: Anaesthesia for awake craniotomy evolution of technique that facilitates awake neurological testing. Brit J Anaest 90(2):161-165, 2003
28. Tan TC, Black P: Image-guided craniotomy for cerebral metastases: Techniques and outcomes. Neurosurgery 53: 82- 90, 2003
29. Taylor MD, Bernstein M: Awake craniotomy with brain mapping as the routine surgical approach to treating patients with supratentorial intraaxial tumors: A prospective trial of 200 cases. J Neurosurg 90(1):35-41,1999
30. Whittle IR: Surgery for gliomas. Curr Opin Neurol 15(6):663- 669, 2002
31. Whittle IR, Borthwick S, Haq N: Brain dysfunction following ‘awake’ craniotomy, brain mapping and resection of glioma. Br J Neurosurg 17(2):130-137, 2003
32. Whittle IR, Midgley S, Georges H, Pringle AM, Taylor R: Patient perceptions of “awake” brain tumour surgery. Acta Neurochir (Wien) 147(3):275-277, 2005
33. Yetkin FZ, Mueller WM, Morris GL, McAuliffe TL, Ulmer JL, Cox RW, Daniels DL, Haughton VM: Functional MR activation correlated with intraoperative cortical mapping. AJNR Am J Neuroradiol 18(7):1311-1315, 1997

APA	Akay A, İŞLEKEL S (2018). Awake Craniotomy Procedure: Its Effects on Neurological Morbidity and Recommendations. , 186 - 192.
Chicago	Akay Ali,İŞLEKEL Sertaç Awake Craniotomy Procedure: Its Effects on Neurological Morbidity and Recommendations. (2018): 186 - 192.
MLA	Akay Ali,İŞLEKEL Sertaç Awake Craniotomy Procedure: Its Effects on Neurological Morbidity and Recommendations. , 2018, ss.186 - 192.
AMA	Akay A,İŞLEKEL S Awake Craniotomy Procedure: Its Effects on Neurological Morbidity and Recommendations. . 2018; 186 - 192.
Vancouver	Akay A,İŞLEKEL S Awake Craniotomy Procedure: Its Effects on Neurological Morbidity and Recommendations. . 2018; 186 - 192.
IEEE	Akay A,İŞLEKEL S "Awake Craniotomy Procedure: Its Effects on Neurological Morbidity and Recommendations." , ss.186 - 192, 2018.
ISNAD	Akay, Ali - İŞLEKEL, Sertaç. "Awake Craniotomy Procedure: Its Effects on Neurological Morbidity and Recommendations". (2018), 186-192.

APA	Akay A, İŞLEKEL S (2018). Awake Craniotomy Procedure: Its Effects on Neurological Morbidity and Recommendations. Turkish Neurosurgery, 28(2), 186 - 192.
Chicago	Akay Ali,İŞLEKEL Sertaç Awake Craniotomy Procedure: Its Effects on Neurological Morbidity and Recommendations. Turkish Neurosurgery 28, no.2 (2018): 186 - 192.
MLA	Akay Ali,İŞLEKEL Sertaç Awake Craniotomy Procedure: Its Effects on Neurological Morbidity and Recommendations. Turkish Neurosurgery, vol.28, no.2, 2018, ss.186 - 192.
AMA	Akay A,İŞLEKEL S Awake Craniotomy Procedure: Its Effects on Neurological Morbidity and Recommendations. Turkish Neurosurgery. 2018; 28(2): 186 - 192.
Vancouver	Akay A,İŞLEKEL S Awake Craniotomy Procedure: Its Effects on Neurological Morbidity and Recommendations. Turkish Neurosurgery. 2018; 28(2): 186 - 192.
IEEE	Akay A,İŞLEKEL S "Awake Craniotomy Procedure: Its Effects on Neurological Morbidity and Recommendations." Turkish Neurosurgery, 28, ss.186 - 192, 2018.
ISNAD	Akay, Ali - İŞLEKEL, Sertaç. "Awake Craniotomy Procedure: Its Effects on Neurological Morbidity and Recommendations". Turkish Neurosurgery 28/2 (2018), 186-192.