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Awake craniotomy

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https://www.readbyqxmd.com/read/29346829/intraoperative-seizures-in-awake-craniotomy-for-perirolandic-glioma-resections-that-undergo-cortical-mapping
#1
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...
January 18, 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/29328000/conscious-sedation-with-dexmedetomidine-compared-with-asleep-awake-asleep-craniotomies-in-glioma-surgery-an-analysis-of-180-patients
#2
Eric Suero Molina, Stephanie Schipmann, Isabelle Mueller, Johannes Wölfer, Christian Ewelt, Matthias Maas, Benjamin Brokinkel, Walter Stummer
OBJECTIVE Awake craniotomies have become a feasible tool over time to treat brain tumors located in eloquent regions. Different techniques have been applied in neurooncology centers. Both "asleep-awake-asleep" (asleep) and "conscious sedation" were used subsequently at the authors' neurosurgical department. Since 2013, the authors have only performed conscious sedation surgeries, predominantly using the α2-receptor agonist dexmedetomidine as the anesthetic drug. The aim of this study was to compare both mentioned techniques and evaluate the clinical use of dexmedetomidine in the setting of awake craniotomies for glioma surgery...
January 12, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29295569/extent-of-resection-in-newly-diagnosed-glioblastoma-impact-of-a-specialized-neuro-oncology-care-center
#3
Amer Haj, Christian Doenitz, Karl-Michael Schebesch, Denise Ehrensberger, Peter Hau, Kurt Putnik, Markus J Riemenschneider, Christina Wendl, Michael Gerken, Tobias Pukrop, Alexander Brawanski, Martin A Proescholdt
Treatment of glioblastoma (GBM) consists of microsurgical resection followed by concomitant radiochemotherapy and adjuvant chemotherapy. The best outcome regarding progression free (PFS) and overall survival (OS) is achieved by maximal resection. The foundation of a specialized neuro-oncology care center (NOC) has enabled the implementation of a large technical portfolio including functional imaging, awake craniotomy, PET scanning, fluorescence-guided resection, and integrated postsurgical therapy. This study analyzed whether the technically improved neurosurgical treatment structure yields a higher rate of complete resection, thus ultimately improving patient outcome...
December 25, 2017: Brain Sciences
https://www.readbyqxmd.com/read/29261148/advances-in-brain-tumor-surgery-for-glioblastoma-in-adults
#4
REVIEW
Montserrat Lara-Velazquez, Rawan Al-Kharboosh, Stephanie Jeanneret, Carla Vazquez-Ramos, Deependra Mahato, Daryoush Tavanaiepour, Gazanfar Rahmathulla, Alfredo Quinones-Hinojosa
Glioblastoma (GBM) is the most common primary intracranial neoplasia, and is characterized by its extremely poor prognosis. Despite maximum surgery, chemotherapy, and radiation, the histological heterogeneity of GBM makes total eradication impossible, due to residual cancer cells invading the parenchyma, which is not otherwise seen in radiographic images. Even with gross total resection, the heterogeneity and the dormant nature of brain tumor initiating cells allow for therapeutic evasion, contributing to its recurrence and malignant progression, and severely impacting survival...
December 20, 2017: Brain Sciences
https://www.readbyqxmd.com/read/29241172/neurophysiological-monitoring-and-awake-craniotomy-for-resection-of-intracranial-gliomas
#5
Taiichi Saito, Manabu Tamura, Mikhail F Chernov, Soko Ikuta, Yoshihiro Muragaki, Takashi Maruyama
Aggressive resection of intracranial gliomas has a positive impact on patients' prognosis, but is associated with a risk of neurological complications. For preservation of brain functions and avoidance of major postoperative morbidity various methods of intraoperative neurophysiological monitoring have been introduced into clinical practice. At present, somatosensory evoked potentials (SSEP), motor evoked potentials (MEP), visual evoked potentials (VEP), brainstem auditory evoked potentials (BAEP), and electrocorticography (ECoG) are used routinely during neurosurgical procedures...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29219753/resection-of-primary-motor-cortex-tumors-feasibility-and-surgical-outcomes
#6
Stephen T Magill, Seunggu J Han, Jing Li, Mitchel S Berger
OBJECTIVE Brain tumors involving the primary motor cortex are often deemed unresectable due to the potential neurological consequences that result from injury to this region. Nevertheless, we have challenged this dogma for many years and used asleep, as well as awake, intraoperative stimulation mapping to maximize extent of resection. It remains unclear whether these tumors can be resected with acceptable morbidity, whether performing the surgery with the patient awake or asleep impacts extent of resection, and how stimulation mapping influences outcomes...
December 8, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29185406/anaesthetic-management-of-supratentorial-tumor-craniotomy-using-awake-throughout-approach
#7
Faraz Shafiq, Fahad Salim, Ather Enam, Jai Parkash, Mohammad Faheem
The authors are reporting an anaesthetic management of patient presenting with left parietal lobe space occupying lesion and scheduled for Awake-craniotomy. Awake-throughout approach using scalp block was planned. Among techniques reported for keeping patient awake during the surgery, this one is really underutilized. The successful conduct requires thorough preoperative assessment and psychological preparation. We used powerpoint presentation as a preoperative teaching tool. The anatomical landmark technique was used to institute scalp block, where individual nerves were targeted bilaterally...
December 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29168669/awake-craniotomy-versus-craniotomy-under-general-anesthesia-for-the-surgical-treatment-of-insular-glioma-choices-and-outcomes
#8
B Y Gravesteijn, M E Keizer, A J P E Vincent, J W Schouten, R J Stolker, M Klimek
OBJECTIVE: To investigate differences in outcomes in patients who underwent surgery for insular glioma using an awake craniotomy (AC) vs. a craniotomy under general anesthesia (GA). METHODS: Data from patients treated at our hospital between 2005 and 2015 were analyzed retrospectively. The preoperative, intraoperative, postoperative, and longer term follow-up characteristics and outcomes of patients who underwent surgery for primary insular glioma using either an AC or GA were compared...
November 23, 2017: Neurological Research
https://www.readbyqxmd.com/read/29135699/phenytoin-induced-excessive-sedation-during-awake-craniotomy-an-unusual-observation
#9
Ankur Khandelwal, Navdeep Sokhal, Niraj Kumar, Shalendra Singh, Suman Sokhal
No abstract text is available yet for this article.
November 10, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/29135526/case-report-of-an-awake-craniotomy-in-a-patient-with-eisenmenger-syndrome
#10
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...
November 9, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29111806/deep-vs-awake-extubation-for-craniotomies
#11
Gahan Bose, Robert John
No abstract text is available yet for this article.
November 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29105013/is-non-awake-surgery-for-supratentorial-adult-low-grade-glioma-treatment-still-feasible
#12
REVIEW
Hugues Duffau
In this short review, the author performs a database search, summarizes, and discusses studies that provide information on the need to perform awake surgery to preserve quality of life/return to work of adult patients who undergo resection for a supratentorial low-grade glioma (LGG). Based upon the currently available data, the author concludes that in LGG, patients with no or only mild deficits at diagnosis, non-awake surgery can no longer be achieved. Indeed, awake craniotomy with intrasurgical electrical mapping has resulted in an increase of the extent of resection and overall survival in LGG...
January 2018: Neurosurgical Review
https://www.readbyqxmd.com/read/29099148/awake-craniotomy-procedure-its-effects-on-neurological-morbidity-and-recommendations
#13
Ali Akay, Sertac Islekel
AIM: The purpose of the current study is to present our experience of 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 are pediatric cases with lesions localized in the functional area- who were operated with AC method between September 2011 and January 2016 in our clinic...
March 25, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/29078728/multicentric-high-grade-oligodendroglioma-a-rare-entity
#14
Atul Vats, Amit Amit, Paresh Doshi
A 74 year old male presented with 1 month history of weakness in right upper limb and motor aphasia for 15 days. Magnetic resonance imaging (MRI) of the brain showed three discrete ring enhancing lesions. An image guided awake craniotomy and biopsy of a lesion was performed. The histopathological examination revealed it to be a grade III Oligodendroglioma. This was a rare case of multicentric high grade oligodendroglioma has never been reported in literature. We report such a case with relevant review of literature...
October 27, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29076979/the-impact-of-intraoperative-magnetic-resonance-imaging-on-patient-safety-management-during-awake-craniotomy
#15
Kotoe Kamata, Takashi Maruyama, Hiroshi Iseki, Minoru Nomura, Yoshihiro Muragaki, Makoto Ozaki
BACKGROUND: Awake craniotomy paired with intraoperative magnetic resonance imaging (iMRI) is now the established technique for maximizing surgical resection, while preserving neurological function. However, leaving an unsecured airway patient in the iMRI gantry represents considerable risk. Our study aimed at identifying the incidence of critical adverse events in unsecured airway patients during iMRI as part of awake craniotomy. MATERIALS AND METHODS: We conducted a clinical chart review of consecutive awake craniotomies performed between November 1999 and December 2015...
October 25, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/29045270/macroglossia-during-awake-craniotomy-a-near-miss
#16
John Cormack, Shravya Karna
No abstract text is available yet for this article.
October 17, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28989049/individual-variability-of-the-human-cerebral-cortex-identified-using-intraoperative-mapping
#17
Johan Pallud, Marc Zanello, Grégory Kuchcinski, Alexandre Roux, Jun Muto, Charles Mellerio, Edouard Dezamis, Catherine Oppenheim
BACKGROUND: The intraoperative functional cortical mapping using direct electrical stimulation may show a wider individual variability than those suggested by non-invasive imaging data on healthy subjects. METHODS: We assessed the intraoperative variability of the frontal eye fields and of the speech arrest sites in adult patients having undergone a wide-awake craniotomy with direct electrostimulation for diffuse gliomas located within eloquent regions and we compared with the human cortical parcellation of the Human Connectome Project (Glasser, Nature, 2016)...
October 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28987835/quality-and-quantity-of-memories-in-patients-who-underwent-awake-brain-tumor-resection
#18
Markus Klimek, Paul H van der Horst, Sanne E Hoeks, Robert Jan Stolker
OBJECTIVE: Awake craniotomy is performed with increasing frequency for brain tumor surgery in eloquent areas. However, little is known about patient's memories of this procedure. Therefore, we retrospectively analyzed quality and quantity of memories, in our patients, treated following a standardized protocol. METHODS: We treated 61 consecutive patients within 3 years. 48 of them were alive, when the study was performed. These patients received a questionnaire about their peri-operative memories and perceptions...
October 4, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28960172/resting-state-functional-magnetic-resonance-imaging-for-surgical-planning-in-pediatric-patients-a-preliminary-experience
#19
Jarod L Roland, Natalie Griffin, Carl D Hacker, Ananth K Vellimana, S Hassan Akbari, Joshua S Shimony, Matthew D Smyth, Eric C Leuthardt, David D Limbrick
OBJECTIVE Cerebral mapping for surgical planning and operative guidance is a challenging task in neurosurgery. Pediatric patients are often poor candidates for many modern mapping techniques because of inability to cooperate due to their immature age, cognitive deficits, or other factors. Resting-state functional MRI (rs-fMRI) is uniquely suited to benefit pediatric patients because it is inherently noninvasive and does not require task performance or significant cooperation. Recent advances in the field have made mapping cerebral networks possible on an individual basis for use in clinical decision making...
September 29, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28953623/intraoperative-neuromonitoring-during-brain-arteriovenous-malformation-microsurgeries-and-postoperative-dysfunction-a-retrospective-follow-up-study
#20
Qian Zhou, Mengjun Li, Lei Yi, Bifen He, Xinxin Li, Yugang Jiang
To evaluate the effectiveness of intraoperative neuromonitoring (IONM) during arteriovenous malformation (AVM) surgery, we retrospectively analyzed neurologic dysfunction in patients who underwent AVM surgery with (IONM group) and without IONM (non-IONM group). The sensitivity and specificity of short-term neurologic dysfunction were calculated in the IONM group. IONM parameters were obtained in all patients. There was no significant difference in neurologic dysfunction between patients in the IONM and non-IONM groups...
September 2017: Medicine (Baltimore)
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