Objective: Despite benefits of awake craniotomy (AC) many centers do not have access to it. We demonstrated the oncological and functional results of our initial experience in implementing AC in a context of resource limited setting.
Methods: This prospective, observational, and descriptive study collected the first 51 AC for diffuse low-grade glioma, classified according to the 2016 World Health Organization.
Results: Mean age was 35.09 ± 9.91 years old. The most common clinical presentation was seizure (89.58%). The average segmented volume was 69.8 cc; with 51% of lesions with more than 6 cm in the largest diameter. Resection of more than 90% of the lesion was achieved in 49% of cases, and greater than 80% in 66.6% of cases. The mean follow-up was 835 days (2.29 years). Satisfactory Karnofsky performance status (KPS) (80 to 100) was observed in 90.1% presurgery, 50.9% at 5 days, 93.7% at 3 months, and 89.7% at 1-year postoperation. At multivariate analysis, tumor volume, new postoperative deficit, and extent of resection were related to KPS at 1 year of follow up.
Conclusions: Functional decline was clearly observed in the immediate postoperative period, but excellent recovery of functional status was observed in the medium and long term. The data presented indicate the benefits of this mapping in both cerebral hemispheres, addressing several cognitive functions in addition to motricity and language. The proposed AC model is a reproducible technique and resource sparing that can be performed safely and with good functional outcomes.
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http://dx.doi.org/10.1016/j.wneu.2023.06.096 | DOI Listing |
World 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.
View Article and Find Full Text PDFInt J Comput Assist Radiol Surg
December 2024
Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan.
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