Awake craniotomy procedure: its effects on neurological morbidity and recommendations
Makaleler > Tam Makale · 2017
Yazarlar: Ali Akay, Sertac Islekel
Turkish Neurosurgery, Uluslararası, 2017, cilt 28, ss 186-192
DOI: 10.5137/1019-5149.jtn.19391-16.1
Özet
tumor that would remain and the major morbidity that may develop are the most important factors affecting survival in glial tumor surgery, where the boundaries between the tumor and the normal brain tissue are lost.Therefore, AC is a reliable method to apply maximum tumor resection with minimum morbidity.Again, in patients with cardiac and respiratory risks to a degree that may not be operated with general anesthesia, the excision of brain lesions may be performed with AC.In this article, we present the AC method that we performed on 46 patients at our clinic between September 2011 and January 2016 and the outcomes of our practice.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.