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Awake microsurgical management of brain aneurysms: a comprehensive systematic review and meta-analysis on rationale, safety and clinical outcomes.
Neurochirurgie
November 2024
Department of Neurosurgery, Loma Linda University Medical Center, Loma Linda, California, USA.
Article Synopsis
- Awake microsurgery is a way to treat brain aneurysms while the patient is awake, allowing doctors to monitor their brain activity during the surgery.
- In a study analyzing 75 patients, the procedure had very few complications, with no permanent issues reported, and it was successful in repairing aneurysms in all cases.
- More research is needed to confirm that this method is safer and better than current surgical options, but it shows promise for helping patients recover more easily.
Combined use of intraoperative MRI and awake tailored microsurgical resection to respect functional neural networks: preliminary experience.
Swiss Med Wkly
May 2023
Centre Hospitalier Regional Universitaire de Lille, Roger Salengro Hospital, Neurosurgery and Neurooncology Service, Lille, France.
Introduction: The combined use of intraoperative MRI and awake surgery is a tailored microsurgical resection to respect functional neural networks (mainly the language and motor ones). Intraoperative MRI has been classically considered to increase the extent of resection for gliomas, thereby reducing neurological deficits. Herein, we evaluated the combined technique of awake microsurgical resection and intraoperative MRI for primary brain tumours (gliomas, metastasis) and epilepsy (cortical dysplasia, non-lesional, cavernomas).
View Article and Find Full Text PDFAcute airway obstruction requiring nasotracheal intubation following hypoglossal neuromonitoring: a case report.
BMC Anesthesiol
May 2023
Department of Anesthesiology and Perioperative Care, University of California Irvine Medical Center, 101 The City Drive South, Orange, CA, 92868, USA.
Background: Intraoperative neurophysiological monitoring (IONM) is utilized for both the localization of critical structures and for real time detection and prevention of intraoperative neurological injury. Use of IONM to monitor the hypoglossal nerve is performed during neurosurgical, otolaryngological, and vascular procedures to improve surgical outcomes. There is a paucity of literature describing potential complications of IONM of the hypoglossal nerve, especially with respect to airway compromise.
View Article and Find Full Text PDFHow to combine the use of intraoperative magnetic resonance imaging (MRI) and awake craniotomy for microsurgical resection of hemorrhagic cavernous malformation in eloquent area: a case report.
J Med Case Rep
April 2023
Neurosurgery and Neurooncology Service Lille, Centre Hospitalier Regional Universitaire de Lille, Roger Salengro Hospital, Lille, France.
Article Synopsis
- - The text discusses a case of a 27-year-old male patient who underwent awake surgery for a cavernous malformation in a sensitive brain area that caused hemorrhage and epilepsy, using advanced imaging techniques.
- - The surgery involved a combination of preoperative diffusion tensor imaging, neuronavigation, and intraoperative MRI to successfully remove the malformation, despite patient movement during the procedure.
- - Post-surgery, the patient experienced a single seizure but showed no significant complications, and follow-up imaging confirmed complete removal of the malformation with normal cognitive function reported in neuropsychological tests.
Surgical Outcomes of Awake Craniotomy for Treatment of Arteriovenous Malformations in Eloquent Cortex: A Systematic Review.
World Neurosurg
July 2023
Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA. Electronic address:
Objective: Arteriovenous malformations (AVMs) located in eloquent brain regions are historically associated with a poor prognosis. Awake craniotomy (AC) with the adjunct of brain mapping has the potential of identifying non-eloquent gyri to maximize resection, thereby theoretically decreasing the risk of neurologic deficits. With limited evidence regarding the efficacy of AC in treatment of eloquent AVMs, this review aims to investigate its surgical outcomes.
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