Usefulness of Awake Craniotomy for Low-grade Gliomas in Eloquent Areas

Abstract

The biggest dilemma in a neurosurgeon's mind while operating upon low-grade gliomas in eloquent areas is-how to achieve maximal tumor excision while preserving the neurological function. This aim is difficult to achieve once patient is under general anesthesia and hence, patient cooperation cannot be sought to know the neurological function. A novel method to overcome this hurdle is to excise gliomas (especially in eloquent areas) in awake stage while constantly seeking patient cooperation to know the corresponding neurological function. In this study, we operated 10 patients in awake stage and achieved reasonable tumor excision with no added deficits at 3 months follow-up. Hence, this technique achieves a compromise between oncological principle of maximal tumor excision while simultaneously following the neurosurgical principle of no new added deficits.