Is awake craniotomy an ideal technique for surgical resection of tumors involving the motor area? Analysis of functional outcomes

Camporeze, Bruno; Galafassi, Giovanna Zambo; Caggiano, Chiara; Tortoro, Nicole; Gripp, Daniel Andrade; Maldaun, Marcos Vinicius Calfatt; Aguiar, Paulo Henrique Pires de

doi:10.23736/s0390-5616.20.04922-x

Cited by 3 publications

(4 citation statements)

References 3 publications

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“…Awake craniotomy and language mapping with electrical stimulation are being applied with increasing frequency to avoid postoperative language dysfunction when tumors are located close to the eloquent area associated with language. [139][140][141][142][143][144] Surgical accuracy may be improved by combining awake craniotomy and ioMR imaging. 142,[145][146][147] When awake craniotomy is performed, special anesthetic management is required and must be performed by an expert anesthesiologist.…”

Section: Awake Craniotomymentioning

confidence: 99%

“…[139][140][141][142][143][144] Surgical accuracy may be improved by combining awake craniotomy and ioMR imaging. 142,[145][146][147] When awake craniotomy is performed, special anesthetic management is required and must be performed by an expert anesthesiologist. 145 In addition, language tasks might be performed by speech therapists and psychologists before and after awake craniotomy.…”

Section: Awake Craniotomymentioning

confidence: 99%

“…140 Awake surgery is a useful method when the tumor is located in the language-dominant hemisphere. 141,142 Full anesthesia is initially induced before craniotomy. 58 After the craniotomy, the dura mater is blocked with local anesthesia, the dura is opened, and the patient is gradually awakened.…”

Section: Awake Craniotomymentioning

confidence: 99%

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Intraoperative MR Imaging during Glioma Resection

2022

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One of the major issues in the surgical treatment of gliomas is the concern about maximizing the extent of resection while minimizing neurological impairment. Thus, surgical planning by carefully observing the relationship between the glioma infiltration area and eloquent area of the connecting fibers is crucial. Neurosurgeons usually detect an eloquent area by functional MRI and identify a connecting fiber by diffusion tensor imaging. However, during surgery, the accuracy of neuronavigation can be decreased due to brain shift, but the positional information may be updated by intraoperative MRI and the next steps can be planned accordingly. In addition, various intraoperative modalities may be used to guide surgery, including neurophysiological monitoring that provides real-time information (e.g., awake surgery, motorevoked potentials, and sensory evoked potential); photodynamic diagnosis, which can identify high-grade glioma cells; and other imaging techniques that provide anatomical information during the surgery. In this review, we present the historical and current context of the intraoperative MRI and some related approaches for an audience active in the technical, clinical, and research areas of radiology, as well as mention important aspects regarding safety and types of devices.

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Section: Awake Craniotomymentioning

confidence: 99%

Section: Awake Craniotomymentioning

confidence: 99%

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Intraoperative MR Imaging during Glioma Resection

2022

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“…In such procedures, a stable physiological support of applying anesthetic drugs to the central nervous system is not required [ 2 ]. The significant benefits of procedures under regional anesthesia include low risk of anesthesia [ 3 ], short surgery time [ 4 ], reduced incidence of adverse reactions [ 3 , 4 ], low incidence of complications [ 2 , 4 , 5 ], improved surgical outcomes [ 2 , 6 ], shortened hospital stays [ 3 , 4 , 7 , 8 ], and reduced healthcare costs [ 4 , [9] , [10] , [11] ]. More importantly, in the context of the global COVID-19 pandemic, medical teams are more inclined to perform procedures under regional anesthesia if conditions permit.…”

Section: Introductionmentioning

confidence: 99%