Awake craniotomy: A qualitative review and future challenges

Ghazanwy, Mahmood; Chakrabarti, Rajkalyan; Tewari, Anurag

doi:10.4103/1658-354x.140890

Cited by 39 publications

(12 citation statements)

References 83 publications

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“…None of the patients experienced VR sickness and we observed no sympathetic nervous activity reported for this syndrome [ 15 - 20 ]. On the basis of our personal experience and published data, we are convinced that this good tolerance was because of patient preparation and training [ 21 - 23 ]. In total, in the 2 studies (45 patients), we observed afterdischarges in 17 (38%) patients and IOSs in 11 (24%) patients, rates within the range reported in previous studies: 71% for afterdischarges [ 24 ] and 3.4% to 31% for IOSs [ 25 - 29 ].…”

Section: Discussionmentioning

confidence: 99%

Immersive Virtual Reality and Ocular Tracking for Brain Mapping During Awake Surgery: Prospective Evaluation Study

Casanova¹,

Clavreul²,

Soulard³

et al. 2021

J Med Internet Res

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Background Language mapping during awake brain surgery is currently a standard procedure. However, mapping is rarely performed for other cognitive functions that are important for social interaction, such as visuospatial cognition and nonverbal language, including facial expressions and eye gaze. The main reason for this omission is the lack of tasks that are fully compatible with the restrictive environment of an operating room and awake brain surgery procedures. Objective This study aims to evaluate the feasibility and safety of a virtual reality headset equipped with an eye-tracking device that is able to promote an immersive visuospatial and social virtual reality (VR) experience for patients undergoing awake craniotomy. Methods We recruited 15 patients with brain tumors near language and/or motor areas. Language mapping was performed with a naming task, DO 80, presented on a computer tablet and then in 2D and 3D via the VRH. Patients were also immersed in a visuospatial and social VR experience. Results None of the patients experienced VR sickness, whereas 2 patients had an intraoperative focal seizure without consequence; there was no reason to attribute these seizures to virtual reality headset use. The patients were able to perform the VR tasks. Eye tracking was functional, enabling the medical team to analyze the patients’ attention and exploration of the visual field of the virtual reality headset directly. Conclusions We found that it is possible and safe to immerse the patient in an interactive virtual environment during awake brain surgery, paving the way for new VR-based brain mapping procedures. Trial Registration ClinicalTrials.gov NCT03010943; https://clinicaltrials.gov/ct2/show/NCT03010943.

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Section: Discussionmentioning

confidence: 99%

Immersive Virtual Reality and Ocular Tracking for Brain Mapping During Awake Surgery: Prospective Evaluation Study

Casanova¹,

Clavreul²,

Soulard³

et al. 2021

J Med Internet Res

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“…The surgical complications can be presented with focal seizures, generalized seizures, the appearance of a neurological deficit (aphasia, paresis), bleeding, cerebral edema, and air embolism. [ 7 9 ]…”

Section: Discussionmentioning

confidence: 99%

Awake craniotomy without sedation in treatment of patients with lesional epilepsy

2018

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Background:The use of awake craniotomy for surgical treatment of epilepsy was applied in surgery of convexital tumors, arteriovenous malformations, some superficial aneurysms, and stereotactic neurosurgery. The aim of this study was to show the advantages of awake craniotomy without sedation, accompanied by intraoperative neurophysiological monitoring in patients with symptomatic epilepsy.Methods:This article describes the results of surgical treatment in 41 patients with various pathologies; 31 among them suffered from epilepsy.Results:Most frequently, the pathological foci were located in frontal and parietal lobes nearby eloquent brain areas. Irrespective of damage location, simple partial and complex partial seizures were seen almost with the same frequency. Intraoperative mapping of eloquent cortical areas and subcortical tracts without sedation resulted in total resection of pathological area in 75% of cases with low rate of permanent neurological deficit (two patients). Minor perioperative complications, including the decrease in blood pressure in six patients and intraoperative convulsions in two patients, were handled and did not led to operation termination or anesthesia conversion. Excellent seizures control (Engel 1) was achieved in 80% of patients with available catamnesis.Conclusion:Thus, the proposed method allows eliminating the complications associated with sedation and provides radical resection of pathological epileptogenic foci with low complication rate.

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“…Başlangıçta uyanık kraniyotomi için nörolept analjezi kullanılmıştır; fentanil (0.5-0.75 mg/kg) ve droperidol (0.15 mg /kg) şeklinde. Uzun süren sedasyon, nöbetler ve QT aralığının uzamış olması gibi komplikasyonlar gözlenmiştir 76 . Bu nedenle, yerine propofol alternatif olarak sunulmuştur 77 .…”

Section: Uyanık Kraniyotomide Anestezik Ajanların Seçimiunclassified

Perioperative Management and Anesthesia in Epilepsy

Ilgınel

Tunay

Güneş

2018

Arşiv Kaynak Tarama Dergisi

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Epilepsy, which is a paroxysmal clinical disease with recurring seizures, influences a significant proportion of the population. Thus epileptic patients constitute an important component of anesthesia practice. Antiepileptic agents have many physiological and pharmacological effects which may have an effect on anesthesia; and also the anesthetic agents themselves have the capacity to modulate or potentiate seizure activity. In this review, we aimed to reveal the plan of perioperative management of epileptic patients; and also the anesthetic approach specific to current epilepsy surgery.

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Awake craniotomy: A qualitative review and future challenges

Cited by 39 publications

References 83 publications

Immersive Virtual Reality and Ocular Tracking for Brain Mapping During Awake Surgery: Prospective Evaluation Study

Immersive Virtual Reality and Ocular Tracking for Brain Mapping During Awake Surgery: Prospective Evaluation Study

Awake craniotomy without sedation in treatment of patients with lesional epilepsy

Perioperative Management and Anesthesia in Epilepsy

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