Document Detail


Prospective study of awake craniotomy used routinely and nonselectively for supratentorial tumors.
MedLine Citation:
PMID:  17639865     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: The authors prospectively assessed the value of awake craniotomy used nonselectively in patients undergoing resection of supratentorial tumors. METHODS: The demographic features, presenting symptoms, tumor location, histological diagnosis, outcomes, and complications were documented for 610 patients who underwent awake craniotomy for supratentorial tumor resection. Intraoperative brain mapping was used in 511 cases (83.8%). Mapping identified eloquent cortex in 115 patients (22.5%) and no eloquent cortex in 396 patients (77.5%). RESULTS: Neurological deficits occurred in 89 patients (14.6%). In the subset of 511 patients in whom brain mapping was performed, 78 (15.3%) experienced postoperative neurological worsening. This phenomenon was more common in patients with preoperative neurological deficits or in those individuals in whom mapping successfully identified eloquent tissue. Twenty-five (4.9%) of the 511 patients suffered intraoperative seizures, and two of these individuals required intubation and induction of general anesthesia after generalized seizures occurred. Four (0.7%) of the 610 patients developed wound complications. Postoperative hematomas developed in seven patients (1.1%), four of whom urgently required a repeated craniotomy to allow evacuation of the clot. Two patients (0.3%) required readmission to the hospital soon after being discharged. There were three deaths (0.5%). CONCLUSIONS: Awake craniotomy is safe, practical, and effective during resection of supratentorial lesions of diverse pathological range and location. It allows for intraoperative brain mapping that helps identify and protect functional cortex. It also avoids the complications inherent in the induction of general anesthesia. Awake craniotomy provides an excellent alternative to surgery of supratentorial brain lesions in patients in whom general anesthesia has been induced.
Authors:
Demitre Serletis; Mark Bernstein
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  107     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-07-20     Completed Date:  2007-08-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1-6     Citation Subset:  AIM; IM    
Affiliation:
Division of Neurosurgery, Toronto Western Hospital, Toronto, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Brain Mapping / methods
Child
Cognition Disorders / etiology
Craniotomy / methods*
Female
Humans
Intraoperative Complications
Male
Middle Aged
Postoperative Complications
Prospective Studies
Seizures / diagnosis,  etiology,  physiopathology
Supratentorial Neoplasms / diagnosis,  surgery*
Wakefulness*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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