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Awake craniotomy

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https://www.readbyqxmd.com/read/29763748/right-hemisphere-cognitive-functions-from-clinical-and-anatomical-bases-to-brain-mapping-during-awake-craniotomy-part-i-clinical-and-functional-anatomy
#1
REVIEW
Florian Bernard, Jean-Michel Lemée, Aram Ter Minassian, Philippe Menei
The non-dominant hemisphere (usually the right) is responsible for primary cognitive functions such as visuo-spatial and social cognition. Awake surgery using direct electrical stimulation for right cerebral tumor removal remains challenging due to the complexity of the functional anatomy and difficulties in adapting standard bedside tasks to awake surgery conditions. An understanding of semiology and anatomical bases, along with an analysis of the available cognitive tasks for visuo-spatial and social cognition per operative mapping will allow neurosurgeons to better appreciate the functional anatomy of the right hemisphere and its relevance to tumor surgery...
May 12, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29739181/accidental-intracerebral-injection-and-seizure-during-scalp-nerve-blocks-for-awake-craniotomy-in-a-previously-craniotomized-patient
#2
Woo Kyung Lee, Hyunzu Kim, Myung-Il Bae, Seung Ho Choi, Kyeong Tae Min
A 34-year-old man who previously underwent a craniotomy due to oligodendroglioma was admitted with a diagnosis of recurrent brain tumor. An awake craniotomy was planned. Approximately 15 minutes after completing the scalp nerve block, his upper torso suddenly moved and trembled for 10 seconds, suggesting a generalized clonic seizure. He recovered gradually and fully in 55 minutes without any neurological sequelae. The emergency computed tomography scan revealed a localized fluid collection and small intracerebral hemorrhage nearby in the temporoparietal cortex beneath the skull defect...
May 9, 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29708913/case-report-of-an-awake-craniotomy-in-a-patient-with-eisenmenger-syndrome
#3
Boris D Heifets, Erin Crawford, Ethan Jackson, Jessica Brodt, Richard A Jaffe, Mark A Burbridge
We present a detailed report of an awake craniotomy for recurrent third ventricular colloid cyst in a patient with severe pulmonary arterial hypertension in the setting of Eisenmenger syndrome, performed 6 weeks after we managed the same patient for a more conservative procedure. This patient has a high risk of perioperative mortality and may be particularly susceptible to perioperative hemodynamic changes or fluid shifts. The risks of general anesthesia induction and emergence must be balanced against the risks inherent in an awake craniotomy on a per case basis...
May 1, 2018: A&A practice
https://www.readbyqxmd.com/read/29694662/technique-of-localizing-the-central-sulcus-under-awaking-anesthesia-for-treatmeat-of-gliomas-in-or-near-motor-areas
#4
Wan Yi, Shujun Xu, Xingang Li, Xiangyu Ma
AIM: This study aimed to study the protective effect of intraoperative awakening and central sulcus location on motor function for patients with gliomas located in motor areas. METHODS: A total of 68 patients with gliomas in motor areas were intubated with a laryngeal mask and rapidly underwent craniotomy without scalp clips and awakening, followed by localization of the central sulcus by somatosensory evoked potential. To protect brain function, we resected the greatest degree of tumor as possible and then finished the close-skull under an awakened state or general anesthesia...
April 6, 2018: Turkish Neurosurgery
https://www.readbyqxmd.com/read/29682064/awake-craniotomy-with-noninvasive-brain-mapping-by-3-tesla-functional-magnetic-resonance-imaging-for-excision-of-low-grade-glioma-a-case-of-a-young-patient-from-pakistan
#5
Atta Ul Aleem Bhatti, Nasir Khan Jakhrani, Maria Adnan Parekh
The past few years have seen increasing support for gross total resection in the management of low-grade gliomas (LGGs), with a greater extent of resection correlated with better overall survival, progression-free survival, and time to malignant transformation. There is consistent evidence in literature supporting extent of safe resection as a good prognostic indicator as well as positively affecting seizure control, symptomatic relief in pressure symptoms, and longer progression-free and total survival. The operative goal in most LGG cases is to maximize the extent of resection for these benefits while avoiding postoperative neurologic deficits...
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29628833/efficacy-and-safety-of-dexmedetomidine-infusion-for-patients-undergoing-awake-craniotomy-an-observational-study
#6
Charu Mahajan, Girija Prasad Rath, Gyaninder Pal Singh, Nitasha Mishra, Suman Sokhal, Parmod Kumar Bithal
Background: The goal of awake craniotomy is to maintain adequate sedation, analgesia, respiratory, and hemodynamic stability and also to provide a cooperative patient for neurologic testing. An observational study carried out to evaluate the efficacy of dexmedetomidine sedation for awake craniotomy. Materials and Methods: Adult patients with age >18 year who underwent awake craniotomy for intracranial tumor surgery were enrolled. Those who were uncooperative and had difficult airway were excluded from the study...
April 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29570009/improvement-in-cognitive-function-after-surgery-for-low-grade-glioma
#7
Ori Barzilai, Shlomit Ben Moshe, Razi Sitt, Gal Sela, Ben Shofty, Zvi Ram
OBJECTIVE Cognition is a key component in health-related quality of life (HRQoL) and is currently incorporated as a major parameter of outcome assessment in patients treated for brain tumors. The effect of surgery on cognition and HRQoL remains debatable. The authors investigated the impact of resection of low-grade gliomas (LGGs) on cognition and the correlation with various histopathological markers. METHODS A retrospective analysis of patients with LGG who underwent craniotomy for tumor resection at a single institution between 2010 and 2014 was conducted...
March 23, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29564654/glioma-surgery-with-intraoperative-mapping-balancing-the-onco-functional-choice
#8
Jannick Brennum, Christina M Engelmann, Johanne Asperud Thomsen, Jane Skjøth-Rasmussen
BACKGROUND: Balancing survival versus risk of inducing functional deficits is a challenge when resecting gliomas in or near eloquent areas. Our objectives were to assess deficits prior to and at 6 and 12 months after awake craniotomies with cortical and subcortical mapping in patients with suspected grade 2 gliomas in eloquent areas. We analyzed whether pre- and intraoperative factors were linked to an increased risk of postoperative deficits. METHOD: Retrospective study of 92 consecutive patients operated between January 2010 and June 2014...
March 22, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29530384/awake-craniotomy-for-excision-of-arteriovenous-malformations-a-qualitative-comparison-study-with-stereotactic-radiosurgery
#9
David Yuen Chung Chan, Danny Tat Ming Chan, Cannon Xian Lun Zhu, Patricia Kwok Yee Kan, Amelia Yikjin Ng, Yi-Pin Sonia Hsieh, Jill Abrigo, Wai Sang Poon, George Kwok Chu Wong
Treatment of arteriovenous malformations (AVM) located at the eloquent area has been a challenge. Awake brain mapping allows identification of a non-eloquent gyrus for intervention and can potentially facilitate resection with preservation of functions. An alternative treatment option is stereotactic radiosurgery (SRS). The objective of this study was to perform a qualitative comparison of the treatment outcome of awake AVM excision versus SRS. We conducted a 13-year retrospective review of AVM excision under awake craniotomy performed at Prince of Wales Hospital, Hong Kong, from 2003 to 2016...
May 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29527392/adult-hemispheric-cerebellar-medulloblastoma
#10
Felipe de Oliveira, José Alberto Landeiro, Igor de Castro
Background: Medulloblastoma is an embryonal neoplasm and accounts for 1% of all adult intracranial tumors. It is associated with many familiar cancer syndromes, but there is no known cause for medulloblastoma. Many studies have documented differences between childhood and adult medulloblastomas in terms of location, proliferation, and apoptotic indices. There are four histological groups - classic and the variant forms (desmoplastic/nodular, anaplasic, and large cell). There are four major subgroups according to molecular configuration: wingless (WNT), sonic hedgehog (SHH), group 3, and group 4 with differences between them according to prognostic outcomes...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29490917/high-frequency-oscillations-in-awake-patients-undergoing-brain-tumor-related-epilepsy-surgery
#11
Anteneh M Feyissa, Gregory A Worrell, William O Tatum, Deependra Mahato, Benjamin H Brinkmann, Steven S Rosenfeld, Karim ReFaey, Perry S Bechtle, Alfredo Quinones-Hinojosa
OBJECTIVE: To examine the relationship between high-frequency oscillations (HFOs) and the presence of preoperative seizures, World Health Organization tumor grade, and isocitrate dehydrogenase 1 (IDH1) mutational status in gliomas. METHODS: We retrospectively studied intraoperative electrocorticography recorded in 16 patients with brain tumor (12 presenting with seizures) who underwent awake craniotomy and surgical resection between September 2016 and June 2017...
March 27, 2018: Neurology
https://www.readbyqxmd.com/read/29490011/awake-surgery-for-a-violin-player-monitoring-motor-and-music-performance-a-case-report
#12
Vitória Piai, Sandra H Vos, Reinhard Idelberger, Pauline Gans, Jonne Doorduin, Mark Ter Laan
Objective: We report the case of a professional violin player who underwent an awake craniotomy to resect a tumor in the left supplementary motor area, an area involved in motor planning. Method: A careful pre- and intraoperative monitoring plan for music performance and complex motor function was established that could be used in combination with cortical stimulation. Results: The patient suffered an epileptic seizure during cortical stimulation...
February 27, 2018: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
https://www.readbyqxmd.com/read/29470316/protecting-the-brain-with-xenon-anesthesia-for-neurosurgical-procedures
#13
Anna Rylova, Mervyn Maze
Xenon possesses some, but not all, of the clinical features of an ideal anesthetic agent. Besides well-known advantages of rapid awakening, stable hemodynamics and lack of biotransformation, preclinical data lead to the expectation of xenon's advantageous use for settings of acute ongoing brain injury; a single randomized clinical trial using an imaging biomarker for assessing brain injury corroborated xenon's preclinical efficacy in protecting the brain from further injury. In this review, we discuss the mechanisms and hence the putative applications of xenon for brain protection in neurosurgery...
February 21, 2018: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/29456901/awake-craniotomy-for-the-treatment-of-a-cortical-pseudoaneurysm-in-a-pregnant-patient
#14
Hirad Hedayat, Daniel R Felbaum, John E Reynolds, Rashid M Janjua
Neurosurgical pathologies presenting during pregnancy are uncommon. If present, the situation creates a unique diagnostic, observational, and therapeutic challenge as both lives are placed at potential risk. Surgical procedures during pregnancy are approached carefully as physiological stressors associated with surgery and anesthesia may cause fetal or maternal compromise. We present the only known case of a pseudoaneurysm treated with an awake craniotomy, allowing us to abate the risks associated with general anesthesia in pregnancy...
December 7, 2017: Curēus
https://www.readbyqxmd.com/read/29452315/technical-aspects-of-awake-craniotomy-with-mapping-for-brain-tumors-in-a-limited-resource-setting
#15
Rafael Teixeira Magalhaes Leal, Bruno Mendonça Barcellos, Jose Alberto Landeiro
BACKGROUND: Brain tumor surgery near or within eloquent regions is increasingly common and is associated with a high risk of neurologic injury. Awake craniotomy with mapping has been shown to be a valid method to preserve neurologic function and increase the extent of resection. However, the technique used varies greatly among centers. Most count on professionals such as neuropsychologists, speech therapists, neurophysiologists, or neurologists to help in intraoperative patient evaluation...
May 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29440926/local-anesthetics-for-brain-tumor-resection-current-perspectives
#16
REVIEW
Jan-Willem Potters, Markus Klimek
This review summarizes the added value of local anesthetics in patients undergoing craniotomy for brain tumor resection, which is a procedure that is carried out frequently in neurosurgical practice. The procedure can be carried out under general anesthesia, sedation with local anesthesia or under local anesthesia only. Literature shows a large variation in the postoperative pain intensity ranging from no postoperative analgesia requirement in two-thirds of the patients up to a rate of 96% of the patients suffering from severe postoperative pain...
2018: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/29390108/dural-and-pial-pain-sensitive-structures-in-humans-new-inputs-from-awake-craniotomies
#17
Denys Fontaine, Fabien Almairac, Serena Santucci, Charlotte Fernandez, Radhouane Dallel, Johan Pallud, Michel Lanteri-Minet
Our knowledge on intracranial pain-sensitive structures in humans comes essentially from observations during neurosurgical procedures performed in awake patients. It is currently accepted that intracranial pain-sensitive structures are limited to the dura mater and its feeding vessels and that small cerebral vessels and pia mater are insensitive to pain, which is inconsistent with some neurosurgical observations during awake craniotomy procedures. We prospectively collected observations of painful events evoked by mechanical stimulation (touching, stretching, pressure, or aspiration) of intracranial structures during awake craniotomies, routinely performed for intraoperative functional mapping to tailor brain tumour resection in the eloquent area...
April 1, 2018: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/29361882/awake-craniotomy-for-assisting-placement-of-auditory-brainstem-implant-in-nf2-patients
#18
Qiangyi Zhou, Zhijun Yang, Zhenmin Wang, Bo Wang, Xingchao Wang, Chi Zhao, Shun Zhang, Tao Wu, Peng Li, Shiwei Li, Fu Zhao, Pinan Liu
OBJECTIVES: Auditory brainstem implants (ABIs) may be the only opportunity for patients with NF2 to regain some sense of hearing sensation. However, only a very small number of individuals achieved open-set speech understanding and high sentence scores. Suboptimal placement of the ABI electrode array over the cochlear nucleus may be one of main factors for poor auditory performance. In the current study, we present a method of awake craniotomy to assist with ABI placement. METHODS: Awake surgery and hearing test via the retrosigmoid approach were performed for vestibular schwannoma resections and auditory brainstem implantations in four patients with NF2...
January 23, 2018: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/29360575/a-high-resolution-computational-localization-method-for-transcranial-magnetic-stimulation-mapping
#19
Shinta Aonuma, Jose Gomez-Tames, Ilkka Laakso, Akimasa Hirata, Tomokazu Takakura, Manabu Tamura, Yoshihiro Muragaki
BACKGROUND: Transcranial magnetic stimulation (TMS) is used for the mapping of brain motor functions. The complexity of the brain deters determining the exact localization of the stimulation site using simplified methods (e.g., the region below the center of the TMS coil) or conventional computational approaches. OBJECTIVE: This study aimed to present a high-precision localization method for a specific motor area by synthesizing computed non-uniform current distributions in the brain for multiple sessions of TMS...
May 15, 2018: NeuroImage
https://www.readbyqxmd.com/read/29346829/intraoperative-seizures-in-awake-craniotomy-for-perirolandic-glioma-resections-that-undergo-cortical-mapping
#20
Chikezie Ikechukwu Eseonu, Jordina Rincon-Torroella, Young M Lee, Karim ReFaey, Punita Tripathi, Alfredo Quinones-Hinojosa
BACKGROUND:  Perirolandic motor area gliomas present invasive eloquent region tumors within the precentral gyrus that are difficult to resect without causing neurologic deficits. STUDY AIMS:  This study evaluates the role of awake craniotomy and motor mapping on neurologic outcome and extent of resection (EOR) of tumor in the perirolandic motor region. It also analyzes preoperative risk factors for intraoperative seizures. METHODS:  We evaluated 57 patients who underwent an awake craniotomy for a perirolandic motor area eloquent region glioma...
May 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
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