Awake craniotomy: first experience
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 10
Abstract
Surgery for infiltrative gliomas aims to balance tumor removal with preservation of functional integrity. Awake craniotomy with intraoperative electrical mapping is a reliable method to minimize the risk of permanent deficit during surgery for low-grade gliomas located within eloquent areas classically considered inoperable. However, it could be argued that preservation of functional sites might lead to a lesser degree of tumor removal. We report our first experience concerning series of patients who underwent awake mapping. Twenty patients underwent surgery for a low-grade glioma in functional sites under local anesthesia in the awake condition with intraoperative electrostimulation. The resection was performed according to functional boundaries at both the cortical and subcortical levels. Postoperative MRI showed that the resection was complete in 4 cases, subtotal in 12 cases and partial removal in 4 cases (paracentral area). All patients returned to normal professional and social lives. Glioma resection using ISM are associated with fewer late severe neurologic deficits and more extensive resection, and they involve eloquent locations more frequently. This indicates that ISM should be universally implemented as standard of care for glioma surgery.
Authors and Affiliations
Atroun. L, Djaafer. M
Keywords
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- EP ID EP244086
- DOI 10.9790/0853-1610075862
- Views 76
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