Surgical treatment of brain tumors, especially those located in the eloquent areas such as anterior temporal, frontal lobes, language, memory areas, and near the motor cortex causes high risk of eloquent impairment. Awake craniotomy displays major rule for maximum resection of the tumor with minimum functional impairment of the Central Nervous System. These case reports discuss the use of awake craniotomy during the brain surgery in Alzahra Hospital, Isfahan, Iran. A 56-year-old woman with left-sided body hypoesthesia since last 3 months and a 25-year-old with severe headache of 1 month duration were operated under craniotomy for brain tumors resection. An awake craniotomy was planned to allow maximum tumor intraoperative testing for resection and neurologic morbidity avoidance. The method of anesthesia should offer sufficient analgesia, hemodynamic stability, sedation, respiratory function, and also awake and cooperative patient for different neurological test. Airway management is the most important part of anesthesia during awake craniotomy. Tumor surgery with awake craniotomy is a safe technique that allows maximal resection of lesions in close relationship to eloquent cortex and has a low risk of neurological deficit.
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http://dx.doi.org/10.4103/2277-9175.115815 | DOI Listing |
Cureus
December 2024
Neurosurgery, Poznan University of Medical Sciences, Poznan, POL.
The present study reports a single-center experience conducted at Józef Struś Multispecialty City Hospital in Poznań, Poland, in diagnosing and treating two patients with primary central nervous system lymphoma (PCNSL), one immunocompetent and one immunodeficient (AIDS). PCNSL is an extremely rare neoplasm with a poor prognosis and non-specific treatment on the basis of immunocompetency. Standard treatment consists of high-dose methotrexate (HD-MTX) being the background of a multimodal therapy, including other chemotherapeutic agents with and without radiation.
View Article and Find Full Text PDFWorld Neurosurg
December 2024
Department of Neurosurgery, University of São Paulo, São Paulo, Brazil.
Background: Arteriovenous Malformations (AVMs) pose a risk of neurologic deterioration, particularly when located in eloquent areas. While awake surgery is well-established for treating low-grade gliomas near eloquent areas, its efficacy for AVMs is less conclusively reported.
Methods: This study conducted a systematic review and individual patient data (IPD) meta-analysis following Cochrane Collaboration and PRISMA guidelines.
Neurooncol Adv
November 2024
Department of Neurological Surgery, University of California, San Francisco, California, USA.
Background: Awake craniotomy (AC) is a technique that balances maximum resection and minimal postoperative deficits in patients with intracranial tumors. To aid in the comparability of functional outcomes after awake surgery, this study investigated its international practice and aimed to define categories of postoperative deficits.
Methods: A survey was distributed via neurosurgical networks in Europe (European Association of Neurosurgical Societies, EANS), the Netherlands (Nederlandse Vereniging voor Neurochirurgie, NVVN), Belgium (Belgian Society of Neurosurgery, BSN), and the United States (Congress of Neurological Surgeons, CNS) between April 2022 and April 2023.
Acta Neurochir (Wien)
December 2024
Department of Neurosurgery, King's College Hospital, Denmark Hill, SE5 9RS, London, UK.
Neuroplasticity is well established in low grade glioma patients. Less is known about functional plasticity in glioblastomas. A 56-year-old lady presented with a recurrent speech deficit seventeen months after her initial craniotomy for a language eloquent glioblastoma (GBM).
View Article and Find Full Text PDFOphthalmic Plast Reconstr Surg
December 2024
Department of Ophthalmology and Visual Science, The University of Texas Health Science Center at Houston, Houston, Texas, U.S.A.
The authors report a rare case of a 58-year-old female with mild right-sided hemifacial spasms and eyelid myokymia and a concomitant high-grade glial mass. This report outlines the clinical presentation, diagnostic approach, and management of right hemifacial spasms and eyelid myokymia. The patient had a 5-month history of gradually worsening right hemifacial spams accompanied by mild right lower eyelid twitching.
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