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Awake craniotomy

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https://www.readbyqxmd.com/read/28059664/navigated-transcranial-magnetic-stimulation-for-glioma-removal-prognostic-value-in-motor-function-recovery-from-postsurgical-neurological-deficits
#1
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
https://www.readbyqxmd.com/read/28059650/surgical-benefits-of-combined-awake-craniotomy-and-intraoperative-magnetic-resonance-imaging-for-gliomas-associated-with-eloquent-areas
#2
Kazuya Motomura, Atsushi Natsume, Kentaro Iijima, Shunichiro Kuramitsu, Masazumi Fujii, Takashi Yamamoto, Satoshi Maesawa, Junko Sugiura, Toshihiko Wakabayashi
OBJECTIVE Maximum extent of resection (EOR) for lower-grade and high-grade gliomas can increase survival rates of patients. However, these infiltrative gliomas are often observed near or within eloquent regions of the brain. Awake surgery is of known benefit for the treatment of gliomas associated with eloquent regions in that brain function can be preserved. On the other hand, intraoperative MRI (iMRI) has been successfully used to maximize the resection of tumors, which can detect small amounts of residual tumors...
January 6, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28034812/surgery-independent-language-function-decline-in-patients-undergoing-awake-craniotomy
#3
Tal Gonen, Gal Sela, Ranin Yanakee, Zvi Ram, Rachel Grossman
BACKGROUND: Despite selection process before awake-craniotomy, some patients experience an unexpected decline in language functions in the operating-room (OR), compared to their baseline evaluation, which may impair their functional monitoring. To investigate this phenomenon we prospectively compared language function day-before surgery and upon entrance to the OR. METHODS: Data was prospectively collected from consecutive patients undergoing awake-craniotomy with intra-operative cortical mapping for resection of gliomas affecting language areas...
December 26, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28027066/complementary-use-of-effect-site-target-controlled-infusion-and-smartpilot-view-for-anesthetic-management-in-semi-awake-craniotomy-near-bis-85
#4
Shimada Mai, Sugawara Ami, Kunisawa Takayuki
No abstract text is available yet for this article.
December 23, 2016: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28003947/the-use-of-the-target-cancellation-task-to-identify-eloquent-visuospatial-regions-in-awake-craniotomies-technical-note
#5
Andrew K Conner, Chad Glenn, Joshua D Burks, Tressie McCoy, Phillip A Bonney, Ahmed A Chema, Justin L Case, Scott Brunner, Cordell Baker, Michael Sughrue
The success of awake craniotomies relies on the patient's performance of function-specific tasks that are simple, quick, and reproducible. Intraoperative identification of visuospatial function through cortical and subcortical mapping has utilized a variety of intraoperative tests, each with its own benefits and drawbacks. In light of this, we developed a simple software program that aids in preventing neglect by simulating a target-cancellation task on a portable electronic device. In this report, we describe the interactive target cancellation task and have reviewed seven consecutive patients who underwent awake craniotomy for parietal and/or posterior temporal infiltrating brain tumors of the non-dominant hemisphere...
November 17, 2016: Curēus
https://www.readbyqxmd.com/read/27989983/optical-neuronavigation-without-rigid-head-fixation-during-awake-surgery
#6
C F Freyschlag, J Kerschbaumer, W Eisner, D Pinggera, K R Brawanski, O Petr, M Bauer, A E Grams, T Bodner, M Seiz, C Thomé
INTRODUCTION: Optical neuronavigation without rigid pin fixation of the head may lead to inaccurate results due to patient's movements in case of awake surgery. The aim of this study was to report our results, using a skull-mounted reference array for optical tracking in patients undergoing awake craniotomy for eloquent gliomas. METHODS: Between March 2013 and December 2014, eighteen consecutive patients (10 male, 8 female) with (fronto-)temporal (n=16) or frontoparietal (perirolandic, n=2) lesions underwent awake craniotomy without rigid pin fixation...
October 27, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27928498/case-report-emergency-awake-craniotomy-for-cerebral-abscess-in-a-patient-with-unrepaired-cyanotic-congenital-heart-disease
#7
Corinne D'Antico, André Hofer, Jens Fassl, Daniel Tobler, Daniel Zumofen, Nicolai Goettel
We report the case of a 39-year-old male with complex cyanotic congenital heart disease undergoing emergency craniotomy for a cerebral abscess. Maintenance of intraoperative hemodynamic stability and adequate tissue oxygenation during anesthesia may be challenging in patients with cyanotic congenital heart disease. In this case, we decided to perform the surgery as an awake craniotomy after interdisciplinary consensus. We discuss general aspects of anesthetic management during awake craniotomy and specific concerns in the perioperative care of patients with congenital heart disease...
2016: F1000Research
https://www.readbyqxmd.com/read/27895359/awake-craniotomy-for-brain-tumours-in-pakistan-an-initial-case-series-from-a-developing-country
#8
Saad Akhtar Khan, Karim Rizwan Nathani, Badar Uddin Ujjan, Muhammad Danish Barakzai, Syed Ather Enam, Faraz Shafiq
Awake craniotomy offers safe resection of brain tumours in eloquent area. Aga Khan University Hospital, Karachi, recently started the programme in Pakistan, and the current study was planned to assess our experience of the first 16 procedures. The retrospective study comprised all such procedures done from November 2015 to May 2016. Pre-operative and post-operative variables were analysed. Of the 16 patients, 11(68.75%) were males and 5(31.25%) were females. The overall median age was 37 years (interquartile range[IQR]: 23-62 years)...
October 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27888341/efficacy-of-the-transtemporal-approach-with-awake-brain-mapping-to-reach-the-dominant-posteromedial-temporal-lesions
#9
Kentaro Iijima, Kazuya Motomura, Lushun Chalise, Masaki Hirano, Atsushi Natsume, Toshihiko Wakabayashi
BACKGROUND: Surgeries for lesions in the dominant hippocampal and parahippocampal gyrus involving the posteromedial temporal regions are challenging to perform because they are located close to Wernicke's area; white matter fibers related with language; the optic radiations; and critical neurovascular structures. We performed a transtemporal approach with awake functional mapping for lesions affecting the dominant posteromedial temporal regions. The aim of this study was to assess the feasibility, safety, and efficacy of awake craniotomy for these lesions...
January 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/27886157/intraoperative-seizures-and-seizures-outcome-in-patients-underwent-awake-craniotomy
#10
Yang Yuan, Zhou Peizhi, Wang Xiang, Liu Yanhui, Liang Ruofei, Jiang Shu, Mao Qing
BACKGROUND: Awake craniotomies (AC) could reduce neurological deficits compared with patients under general anesthesia, however, intraoperative seizure is a major reason causing awake surgery failure. The purpose of the study was to give a comprehensive overview the published articles focused on seizure incidence in awake craniotomy. METHODS: Bibliographic searches of the EMBASE, MEDLINE,were performed to identify articles and conference abstracts that investigated the intraoperative seizure frequency of patients underwent AC...
November 25, 2016: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/27858231/how-i-do-it-awake-craniotomy
#11
Ciaran Scott Hill, Flavio Severgnini, Edward McKintosh
BACKGROUND: Awake craniotomy allows continuous assessment of a patient's clinical and neurological status during open brain surgery. This facilitates early detection of interference with eloquent cortex, and hence can allow a surgeon to maximize resection margins without compromising neurological function. METHODS: Awake craniotomy requires an effective scalp blockade, intraoperative assessment, and a carefully co-ordinated theatre team. A variety of clinical and electrophysiological techniques can be used to assess cortical function...
January 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/27821134/asphyxia-due-to-laryngeal-spasm-as-a-severe-complication-of-awake-deep-brain-stimulation-for-parkinson-s-disease-a-case-report
#12
Kajetan L von Eckardstein, Friederike Sixel-Döring, Stephan Kazmaier, Claudia Trenkwalder, Jason M Hoover, Veit Rohde
BACKGROUND: In accordance with German neurosurgical and neurological consensus recommendations, lead placements for deep brain stimulation (DBS) in patients with Parkinson's disease (PD) are usually performed with the patient awake and in "medication off" state. This allows for optimal lead position adjustment according to the clinical response to intraoperative test stimulation. However, exacerbation of Parkinsonian symptoms after withdrawal of dopaminergic medication may endanger the patient by inducing severe "off" state motor phenomena...
November 8, 2016: BMC Neurology
https://www.readbyqxmd.com/read/27811496/a-case-report-of-onyx-pulmonary-arterial-embolism-contributing-to-hypoxemia-during-awake-craniotomy-for-arteriovenous-malformation-resection
#13
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...
November 2, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27803645/sources-of-variation-influencing-concordance-between-functional-mri-and-direct-cortical-stimulation-in-brain-tumor-surgery
#14
Melanie A Morrison, Fred Tam, Marco M Garavaglia, Gregory M T Hare, Michael D Cusimano, Tom A Schweizer, Sunit Das, Simon J Graham
Object: Preoperative functional magnetic resonance imaging (fMRI) remains a promising method to aid in the surgical management of patients diagnosed with brain tumors. For patients that are candidates for awake craniotomies, surgical decisions can potentially be improved by fMRI but this depends on the level of concordance between preoperative brain maps and the maps provided by the gold standard intraoperative method, direct cortical stimulation (DCS). There have been numerous studies of the concordance between fMRI and DCS using sensitivity and specificity measures, however the results are variable across studies and the key factors influencing variability are not well understood...
2016: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/27771234/comparison-of-conscious-sedation-and-asleep-awake-asleep-techniques-for-awake-craniotomy
#15
Ozlem Korkmaz Dilmen, Eren Fatma Akcil, Abdulvahap Oguz, Hayriye Vehid, Yusuf Tunali
Since awake craniotomy (AC) has become a standard of care for supratentorial tumour resection, especially in the motor and language cortex, determining the most appropriate anaesthetic protocol is very important. The aim of this retrospective study is to compare the effectiveness of conscious sedation (CS) to "awake-asleep-awake" (AAA) techniques for supratentorial tumour resection. Forty-two patients undergoing CS and 22 patients undergoing AAA were included in the study. The primary endpoint was to compare the CS and AAA techniques with respect to intraoperative pain and agitation in patients undergoing supratentorial tumour resection...
January 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27756671/intraoperative-subcortical-electrical-mapping-of-the-optic-tract-in-awake-surgery-using-virtual-reality-headset
#16
Edouard Mazerand, Marc Le Renard, Sophie Hue, Jean-Michel Lemee, Evelyne Klinger, Philippe Menei
BACKGROUND: Brain mapping during awake craniotomy is a well-known technique to preserve neurological functions, especially the language. It is still challenging to map the optic radiations due to the difficulty to test the visual field intraoperatively. OBJECTIVE: To assess the visual field during awake craniotomy, we developed the Functions' Explorer based on a Virtual Reality Headset (FEX-VRH). METHODS: The impaired visual field of ten patients was tested with the gold standard exam (an automated perimetry), and the FEX-VRH...
October 15, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27756098/operative-strategies-during-awake-surgery-affect-deterioration-of-paresis-a-month-after-surgery-for-brain-lesions-in-the-primary-motor-area
#17
Nobusada Shinoura, Akira Midorikawa, Ryoji Yamada, Kentaro Hiromitsu, Chihiro Itoi, Shoko Saito, Kazuo Yagi
Introduction We analyzed factors associated with worsened paresis at 1-month follow-up in patients with brain tumors located in the primary motor area (M1) to establish protocols for safe awake craniotomy for M1 lesions. Methods Patients with M1 brain tumors who underwent awake surgery in our hospital (n = 61) were evaluated before, during, and immediately and 1 month after surgery for severity of paresis, tumor location, extent of resection, complications, preoperative motor strength, histology, and operative strategies (surgery stopped or continued after deterioration of motor function)...
October 18, 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/27727417/vakenkirurgi-vid-l%C3%A3-ggradiga-gliom-rekommenderas-goda-resultat-av-7-%C3%A3-rs-erfarenheter-i-link%C3%A3-ping
#18
Peter Milos, Kerstin Metcalf, Patrick Vigren, Hans Lindehammar, Malin Nilsson, Sverre Boström
Awake craniotomy for brain tumours  Awake neurosurgery is a useful method in lesions near eloquent brain areas, particularly low-grade gliomas.The aim is to maximise tumour resection and preserve neurological function. We performed 40 primary awake surgeries and 8 residual surgeries. Patients were operated awake throughout the procedure or with a laryngeal mask and general anaesthesia during the opening stage and then awake during intracerebral surgery. Language and motor function were mapped with direct cortical stimulation, motor evoked potential and standardised neurological testing...
October 11, 2016: Läkartidningen
https://www.readbyqxmd.com/read/27699123/imaging-brain-activity-during-seizures-in-freely-behaving-rats-using-a-miniature-multi-modal-imaging-system
#19
Iliya Sigal, Margaret M Koletar, Dene Ringuette, Raanan Gad, Melanie Jeffrey, Peter L Carlen, Bojana Stefanovic, Ofer Levi
We report on a miniature label-free imaging system for monitoring brain blood flow and blood oxygenation changes in awake, freely behaving rats. The device, weighing 15 grams, enables imaging in a ∼ 2 × 2 mm field of view with 4.4 μm lateral resolution and 1 - 8 Hz temporal sampling rate. The imaging is performed through a chronically-implanted cranial window that remains optically clear between 2 to > 6 weeks after the craniotomy. This imaging method is well suited for longitudinal studies of chronic models of brain diseases and disorders...
September 1, 2016: Biomedical Optics Express
https://www.readbyqxmd.com/read/27695239/surgical-resection-of-low-grade-gliomas-in-eloquent-areas-with-the-guidance-of-the-preoperative-functional-magnetic-resonance-imaging-and-craniometric-points
#20
Ahmed Abdullah, Hisham El Shitany, Waleed Abbass, Amr Safwat, Amr K Elsamman, Ehab El Refaee
OBJECTIVES: Surgical resection of low-grade gliomas (LGGs) in eloquent areas is one of the challenges in neurosurgery, using assistant tools to facilitate effective excision with minimal postoperative neurological deficits has been previously discussed (awake craniotomy and intraoperative cortical stimulation); however, these tools could have their own limitations thus implementation of a simple and effective technique that can guide to safe excision is needed in many situations. MATERIALS AND METHODS: The authors conducted a retrospective analysis of a prospectively collected data of 76 consecutive surgical cases of LGGs of these 21 cases were situated in eloquent areas...
October 2016: Journal of Neurosciences in Rural Practice
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