Incidencia y causas de finalización anticipada de la cirugía con paciente despierto para mapeo del lenguaje, no relacionadas directamente con la elocuencia

Villalba, Glòria; Pacreu, S.; Fernández-Candil, Juan; León, Alba; Serrano, Laura; Conesa, Gérardo

doi:10.1016/j.neucir.2015.06.001

Cited by 1 publication

(3 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…An awake resection was performed using intraoperative direct cortico-subcortical electrostimulation mapping. The initial cortical mapping (2.5 mA) induced reproducible speech arrest (10), dysarthria (11), and phonemic paraphasia (11). After identification of reproducible phonemic paraphasia (13) in the posterior depth of the superior temporal gyrus, the resection was stopped due to increasing headaches not responsive to analgesics that precluded deep eloquent boundaries to be identified (9.0 cc of residual tumor).…”

Section: Generalizabilitymentioning

confidence: 99%

“…An awake resection was performed using intraoperative direct cortico-subcortical electrostimulation mapping. The initial cortical mapping (2.5 mA) induced reproducible contractions of tongue and lips (1), speech arrest (10), dysarthria and vocalizations (11), paresthesia of the tongue (20) and teeth (21), phonemic paraphasia (12), semantic paraphasia (reproducible in 13, nonreproducible in 14 and 15), and errors in emotion recognition task (16). The function-based resection was tailored using deep eloquent boundaries defined by the subcortical ventral semantic pathway (semantic paraphasia tagged in 17 and 18, latency in 19) and by premotor pathways (arrest of voluntary movements in 2).…”

Section: Generalizabilitymentioning

confidence: 99%

“…The failure of awake surgery has been reported ranging 0.5% to 14.6%. [7][8][9][10][11][12][13] There is a limited understanding of the factors contributing to the poor patient participation intraoperatively.…”

mentioning

confidence: 99%

See 2 more Smart Citations

A Preoperative Scoring System to Predict Function-Based Resection Limitation Due to Insufficient Participation During Awake Surgery

et al. 2023

View full text Add to dashboard Cite

BACKGROUND: Failure in achieving a function-based resection related to the insufficient patient's participation is a drawback of awake surgery. OBJECTIVE: To assess preoperative parameters predicting the risk of patient insufficient intraoperative cooperation leading to the arrest of the awake resection. METHODS: Observational, retrospective, multicentric cohort analysis enrolling 384 (experimental dataset) and 100 (external validation dataset) awake surgeries. RESULTS: In the experimental data set, an insufficient intraoperative cooperation occurred in 20/384 patients (5.2%), leading to awake surgery failure in 3/384 patients (ie, no resection, 0.8%), and precluded the achievement of the function-based resection in 17/384 patients (ie, resection limitation, 4.4%). The insufficient intraoperative cooperation significantly reduced the resection rates (55.0% vs 94.0%, P < .001) and precluded a supratotal resection (0% vs 11.3%, P = .017). Seventy years or older, uncontrolled epileptic seizures, previous oncological treatment, hyperperfusion on MRI, and mass effect on midline were independent predictors of insufficient cooperation during awake surgery (P < .05). An Awake Surgery Insufficient Cooperation score was then assessed: 96.9% of patients (n = 343/354) with a score ≤2 presented a good intraoperative cooperation, while only 70.0% of patients (n = 21/30) with a score >2 presented a good intraoperative cooperation. In the experimental data set, similar date were found: 98.9% of patients (n = 98/99) with a score ≤2 presented a good cooperation, while 0% of patients (n = 0/1) with a score >2 presented a good cooperation. CONCLUSION: Function-based resection under awake conditions can be safely performed with a low rate of insufficient patient intraoperative cooperation. The risk can be assessed preoperatively by a careful patient selection.

show abstract

Section: Generalizabilitymentioning

confidence: 99%

“…An awake resection was performed using intraoperative direct cortico-subcortical electrostimulation mapping. The initial cortical mapping (2.5 mA) induced reproducible contractions of tongue and lips (1), speech arrest (10), dysarthria and vocalizations (11), paresthesia of the tongue (20) and teeth (21), phonemic paraphasia (12), semantic paraphasia (reproducible in 13, nonreproducible in 14 and 15), and errors in emotion recognition task (16). The function-based resection was tailored using deep eloquent boundaries defined by the subcortical ventral semantic pathway (semantic paraphasia tagged in 17 and 18, latency in 19) and by premotor pathways (arrest of voluntary movements in 2).…”

Section: Generalizabilitymentioning

confidence: 99%