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Awake craniotomy

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https://www.readbyqxmd.com/read/28424537/awake-craniotomy-anesthetic-management-using-dexmedetomidine-propofol-and-remifentanil
#1
Andrea Prontera, Stefano Baroni, Andrea Marudi, Franco Valzania, Alberto Feletti, Francesca Benuzzi, Elisabetta Bertellini, Giacomo Pavesi
INTRODUCTION: Awake craniotomy allows continuous monitoring of patients' neurological functions during open surgery. Anesthesiologists have to sedate patients in a way so that they are compliant throughout the whole surgical procedure, nevertheless maintaining adequate analgesia and anxiolysis. Currently, the use of α2-receptor agonist dexmedetomidine as the primary hypnotic-sedative medication is increasing. METHODS: Nine patients undergoing awake craniotomy were treated with refined monitored anesthesia care (MAC) protocol consisting of a combination of local anesthesia without scalp block, low-dose infusion of dexmedetomidine, propofol, and remifentanil, without the need of airways management...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28416090/clipping-in-awake-surgery-as-end-stage-in-a-complex-internal-carotid-artery-aneurysm-after-failure-of-multimodal-endovascular-and-extracranial-intracranial-bypass-treatment
#2
Delia Cannizzaro, Simone Peschillo, Cristina Mancarella, Biagia La Pira, Emanuela Rastelli, Emiliano Passacantilli, Antonio Santoro
BACKGROUND: Intracranial carotid artery aneurysm can be treated via microsurgical or endovascular techniques. The optimal planning is the result of the careful patient selection through clinical, anatomic, and angiographic analysis. CLINICAL PRESENTATION: We present a case of ruptured internal carotid artery (ICA) aneurysm that became a complex aneurysm after failure of multi-endovascular and surgery treatment. We describe complete trapping in awake craniotomy after failure of coiling, stenting, and bypassing...
April 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28384595/clinical-outcomes-from-maximum-safe-resection-of-primary-and-metastatic-brain-tumors-using-awake-craniotomy
#3
Anastasia Groshev, Devang Padalia, Sephalie Patel, Rosemarie Garcia-Getting, Solmaz Sahebjam, Peter A Forsyth, Frank D Vrionis, Arnold B Etame
OBJECTIVE: To retrospectively analyze outcomes in patients undergoing awake craniotomies for tumor resection at our institution in terms of extent of resection, functional preservation and length of hospital stay. PATIENTS AND METHODS: All cases of adults undergoing awake-craniotomy from September 2012-February 2015 were retrospectively reviewed based on an IRB approved protocol. Information regarding patient age, sex, cancer type, procedure type, location, hospital stay, extent of resection, and postoperative complications was extracted...
March 20, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28327904/the-cost-of-brain-surgery-awake-vs-asleep-craniotomy-for-perirolandic-region-tumors
#4
Chikezie I Eseonu, Jordina Rincon-Torroella, Karim ReFaey, Alfredo Quiñones-Hinojosa
BACKGROUND: Cost effectiveness has become an important factor in the health care system, requiring surgeons to improve efficacy of procedures while reducing costs. An awake craniotomy (AC) with direct cortical stimulation (DCS) presents one method to resect eloquent region tumors; however, some authors assert that this procedure is an expensive alternative to surgery under general anesthesia (GA) with neuromonitoring. OBJECTIVE: To evaluate the cost effectiveness and clinical outcomes between AC and GA patients...
March 15, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28327900/awake-craniotomy-vs-craniotomy-under-general-anesthesia-for-perirolandic-gliomas-evaluating-perioperative-complications-and-extent-of-resection
#5
Chikezie I Eseonu, Jordina Rincon-Torroella, Karim ReFaey, Young M Lee, Jasvinder Nangiana, Tito Vivas-Buitrago, Alfredo Quiñones-Hinojosa
BACKGROUND: A craniotomy with direct cortical/subcortical stimulation either awake or under general anesthesia (GA) present 2 approaches for removing eloquent region tumors. With a reported higher prevalence of intraoperative seizures occurring during awake resections of perirolandic lesions, oftentimes, surgery under GA is chosen for these lesions. OBJECTIVE: To evaluate a single-surgeon's experience with awake craniotomies (AC) vs surgery under GA for resecting perirolandic, eloquent, motor-region gliomas...
March 15, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28325009/a-clinic-compatible-open-source-electrophysiology-system
#6
John Hermiz, Nick Rogers, Erik Kaestner, Mehran Ganji, Dan Cleary, Joseph Snider, David Barba, Shadi Dayeh, Eric Halgren, Vikash Gilja
Open source electrophysiology (ephys) recording systems have several advantages over commercial systems such as customization and affordability enabling more researchers to conduct ephys experiments. Notable open source ephys systems include Open-Ephys, NeuroRighter and more recently Willow, all of which have high channel count (64+), scalability, and advanced software to develop on top of. However, little work has been done to build an open source ephys system that is clinic compatible, particularly in the operating room where acute human electrocorticography (ECoG) research is performed...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28319187/the-impact-of-high-grade-glial-neoplasms-on-human-cortical-electrophysiology
#7
S Kathleen Bandt, Jarod L Roland, Mrinal Pahwa, Carl D Hacker, David T Bundy, Jonathan D Breshears, Mohit Sharma, Joshua S Shimony, Eric C Leuthardt
OBJECTIVE: The brain's functional architecture of interconnected network-related oscillatory patterns in discrete cortical regions has been well established with functional magnetic resonance imaging (fMRI) studies or direct cortical electrophysiology from electrodes placed on the surface of the brain, or electrocorticography (ECoG). These resting state networks exhibit a robust functional architecture that persists through all stages of sleep and under anesthesia. While the stability of these networks provides a fundamental understanding of the organization of the brain, understanding how these regions can be perturbed is also critical in defining the brain's ability to adapt while learning and recovering from injury...
2017: PloS One
https://www.readbyqxmd.com/read/28282570/paradoxical-vocal-changes-in-a-trained-singer-by-focally-cooling-the-right-superior-temporal-gyrus
#8
Kalman A Katlowitz, Hiroyuki Oya, Matthew A Howard, Jeremy D W Greenlee, Michael A Long
The production and perception of music is preferentially mediated by cortical areas within the right hemisphere, but little is known about how these brain regions individually contribute to this process. In an experienced singer undergoing awake craniotomy, we demonstrated that direct electrical stimulation to a portion of the right posterior superior temporal gyrus (pSTG) selectively interrupted singing but not speaking. We then focally cooled this region to modulate its activity during vocalization. In contrast to similar manipulations in left hemisphere speech production regions, pSTG cooling did not elicit any changes in vocal timing or quality...
April 2017: Cortex; a Journal Devoted to the Study of the Nervous System and Behavior
https://www.readbyqxmd.com/read/28277256/-anesthetic-considerations-for-awake-craniotomy-case-report
#9
Cassiano Hamacek de Freitas, Celso Homero Santos Oliveira, Daniel Câmara de Rezende, Joyce Romano, Henrique Rodrigues Lemos Silva, Ivana Mares Trivellato
BACKGROUND AND OBJECTIVES: The conscious patient cooperation during neurological procedures has become necessary for the delimitation of areas to be managed by a neurosurgeon, with better results in the treatment of tumor lesions, vascular or epileptic foci, and sequelae minimization. The need for perioperative awareness (responsiveness to commands) challenges anesthesiologists to further ensure patient safety during the procedure. Several techniques have been described for this purpose...
October 26, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28254101/electroacupuncture-assisted-craniotomy-on-an-awake-patient
#10
Amritpal Sidhu, Trushna Murgahayah, Vairavan Narayanan, Hari Chandran, Vicknes Waran
Although acupuncture has existed for over 2000 years, its application as an anesthetic aid began in the 1950s in China. The first surgical procedure performed under acupuncture anesthesia was a tonsillectomy. Soon thereafter, major and minor surgical procedures took place with electroacupuncture alone providing the anesthesia. The procedures performed were diverse, ranging from cardiothoracic surgery to dental extractions. Usage of acupuncture anesthesia, specifically in neurosurgery, has been well documented in hospitals across China, especially in Beijing, dating back to the 1970s...
January 2017: Journal of Acupuncture and Meridian Studies
https://www.readbyqxmd.com/read/28247161/patients-perspective-on-awake-craniotomy-for-brain-tumors-single-center-experience-in-brazil
#11
Rafael Teixeira Magalhaes Leal, Clovis Orlando da Fonseca, Jose Alberto Landeiro
BACKGROUND: Awake craniotomy with brain mapping is the gold standard for eloquent tissue localization. Patients' tolerability and satisfaction have been shown to be high; however, it is a matter of debate whether these findings could be generalized, since patients across the globe have their own cultural backgrounds and may perceive and accept this procedure differently. METHODS: We conducted a prospective qualitative study about the perception and tolerability of awake craniotomy in a population of consecutive brain tumor patients in Brazil between January 2013 and April 2015...
February 28, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28240617/awake-craniotomy-during-pregnancy
#12
Ali M Al Mashani, Azmat Ali, Nilay Chatterjee, Neelam Suri, Samaresh Das
No abstract text is available yet for this article.
February 24, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28227515/a-clinic-compatible-open-source-electrophysiology-system
#13
John Hermiz, Nick Rogers, Erik Kaestner, Mehran Ganji, Dan Cleary, Joseph Snider, David Barba, Shadi Dayeh, Eric Halgren, Vikash Gilja, John Hermiz, Nick Rogers, Erik Kaestner, Mehran Ganji, Dan Cleary, Joseph Snider, David Barba, Shadi Dayeh, Eric Halgren, Vikash Gilja, Erik Kaestner, Mehran Ganji, David Barba, Joseph Snider, Nick Rogers, Shadi Dayeh, Eric Halgren, Vikash Gilja, Dan Cleary, John Hermiz
Open source electrophysiology (ephys) recording systems have several advantages over commercial systems such as customization and affordability enabling more researchers to conduct ephys experiments. Notable open source ephys systems include Open-Ephys, NeuroRighter and more recently Willow, all of which have high channel count (64+), scalability, and advanced software to develop on top of. However, little work has been done to build an open source ephys system that is clinic compatible, particularly in the operating room where acute human electrocorticography (ECoG) research is performed...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28219086/first-report-of-awake-craniotomy-of-a-famous-musician-suprasellar-tumor-surgery-of-pianist-clara-haskil-in-1942
#14
Elena Romana Gasenzer, Ayhan Kanat, Edmund A M Neugebauer
Clara Haskil (January 7, 1895-December 7, 1960) was one of the most famous female pianists of the 20th century. In her life and work she set new standards in piano playing. However, her career was beset by poor health and the adversities of two world wars. In her lifetime Haskil had three major disorders: juvenile scoliosis requiring treatment in her adolescence, a tumor of the sellar region requiring surgery at age 47 years, and a traumatic brain injury causing her death at the age of 65. Her medical history illustrates the development of surgical methods and rehabilitation in medicine before and after World War II...
February 20, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28195862/a-case-report-of-onyx-pulmonary-arterial-embolism-contributing-to-hypoxemia-during-awake-craniotomy-for-arteriovenous-malformation-resection
#15
Brian T Tolly, Jenna L Kosky, Antoun Koht, Laura B Hemmer
A healthy 26-year-old man with cerebral arteriovenous malformation underwent staged endovascular embolization with Onyx followed by awake craniotomy for resection. The perioperative course was complicated by tachycardia and severe intraoperative hypoxemia requiring significant oxygen supplementation. Postoperative chest computed tomography (CT) revealed hyperattenuating Onyx embolization material within the pulmonary vasculature, and an electrocardiogram indicated possible right heart strain, supporting clinically significant embolism...
February 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28181184/anesthesia-for-awake-craniotomy-a-how-to-guide-for-the-occasional-practitioner
#16
Lingzhong Meng, David L McDonagh, Mitchel S Berger, Adrian W Gelb
Awake craniotomy (AC), defined as the performance of at least part of an open cranial procedure with the patient awake, has been tied to beneficial outcomes compared with similar surgery under general anesthesia. Improved anesthetic techniques have made a major contribution to the increasing popularity of AC. However, the heterogeneity of practice among institutions doing large numbers of ACs raises questions (often among those who only occasionally perform AC - i.e., practitioners in low-volume AC institutions) as to the ideal anesthetic technique for AC...
February 8, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28162256/pain-during-awake-craniotomy-for-brain-tumor-resection-incidence-causes-consequences-and-management
#17
D Fontaine, F Almairac
INTRODUCTION: Awake craniotomy for brain tumor resection is usually well-tolerated and most of the patients are satisfied. However, in studies reporting the patients' postoperative perception of the awake craniotomy procedure, about half of them have experienced some degree of intraoperative pain. Pain was mild (intensity between 1 and 2 on the visual analogical score) short lasting in most cases, and did not challenge the procedure. Pain was reported as moderate in about 25% and exceptionally severe...
February 2, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28162255/direct-electrical-bipolar-electrostimulation-for-functional-cortical-and-subcortical-cerebral-mapping-in-awake-craniotomy-practical-considerations
#18
J Pallud, O Rigaux-Viode, R Corns, J Muto, C Lopez Lopez, C Mellerio, X Sauvageon, E Dezamis
INTRODUCTION: The aim of brain glioma surgery is to maximize the quality of resection, while minimizing the risk of sequelae. Due to the frequent location of gliomas near or within eloquent areas, owing to their infiltrative feature, and because of major interindividual variability, the anatomofunctional organization and connectivity must be studied individually. Therefore, to optimize the benefit-to-risk ratio of surgery, intraoperative functional mapping is extensively used. MATERIAL AND METHODS: This article aims at describing the rationale, indications and practical aspects of intraoperative direct electrical bipolar electrostimulation for cortical and subcortical mapping under awake conditions using the asleep-awake asleep anaesthetic protocol in the setting of cerebral gliomas...
February 2, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28120089/awake-craniotomy-for-tumor-resection-further-optimizing-therapy-of-brain-tumors
#19
H Maximilian Mehdorn, Felix Schwartz, Juliane Becker
In recent years more and more data have emerged linking the most radical resection to prolonged survival in patients harboring brain tumors. Since total tumor resection could increase postoperative morbidity, many methods have been suggested to reduce the risk of postoperative neurological deficits: awake craniotomy with the possibility of continuous patient-surgeon communication is one of the possibilities of finding out how radical a tumor resection can possibly be without causing permanent harm to the patient...
2017: Acta Neurochirurgica. Supplement
https://www.readbyqxmd.com/read/28059664/navigated-transcranial-magnetic-stimulation-for-glioma-removal-prognostic-value-in-motor-function-recovery-from-postsurgical-neurological-deficits
#20
Tomokazu Takakura, Yoshihiro Muragaki, Manabu Tamura, Takashi Maruyama, Masayuki Nitta, Chiharu Niki, Takakazu Kawamata
OBJECTIVE The aim of the present study was to evaluate the usefulness of navigated transcranial magnetic stimulation (nTMS) as a prognostic predictor for upper-extremity motor functional recovery from postsurgical neurological deficits. METHODS Preoperative and postoperative nTMS studies were prospectively applied in 14 patients (mean age 39 ± 12 years) who had intraparenchymal brain neoplasms located within or adjacent to the motor eloquent area in the cerebral hemisphere. Mapping by nTMS was done 3 times, i...
January 6, 2017: Journal of Neurosurgery
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