Our Summary

This study compared awake and asleep surgeries for epilepsy to evaluate their safety and effectiveness. The research involved 15 patients who had awake surgery and 30 who had traditional, asleep surgery. Results showed similar levels of control over seizures in both groups, with no significant differences in post-surgery neurological complications. However, the location of the surgery differed significantly between the two groups. Four patients who underwent awake surgery had been previously deemed unsuitable for traditional surgery due to the risk of damaging vital brain areas. This suggests that awake surgery could be a viable option for patients with epilepsy-related areas close to important brain structures.

FAQs

  1. What was the main purpose of the study comparing awake and asleep surgeries for epilepsy?
  2. Were there any significant differences in seizure control or post-surgery complications between the two groups?
  3. Can awake surgery be an alternative for patients who are deemed unsuitable for traditional surgery due to the risk of damaging vital brain areas?

Doctor’s Tip

One helpful tip a doctor might tell a patient about craniotomy is to follow post-operative care instructions carefully, including keeping the incision site clean and dry, taking prescribed medications as directed, and attending follow-up appointments. It is also important to report any unusual symptoms or concerns to the healthcare provider promptly. Additionally, maintaining a healthy lifestyle, including regular exercise and a balanced diet, can help promote healing and recovery after surgery.

Suitable For

Patients who are typically recommended for craniotomy include those with brain tumors, epilepsy, arteriovenous malformations, traumatic brain injuries, and other neurological conditions that require surgical intervention. In particular, awake craniotomy may be recommended for patients with brain tumors or epilepsy whose lesions are located close to important brain structures and require precise mapping and monitoring during surgery.

Timeline

Before craniotomy:

  1. Patient consults with neurosurgeon and undergoes various pre-operative tests such as MRI, CT scans, and blood tests.
  2. Patient may undergo a pre-surgical evaluation to determine the exact location of the seizure focus in the brain.
  3. Patient may be prescribed anti-seizure medication to help manage seizures before surgery.

During craniotomy:

  1. Patient is brought into the operating room and given anesthesia to put them to sleep.
  2. Surgeon makes an incision in the scalp and removes a portion of the skull to access the brain.
  3. Surgeon carefully removes or treats the area of the brain causing seizures.
  4. If awake surgery is being performed, patient may be woken up during the procedure to ensure vital brain functions are not being affected.
  5. Surgeon closes the incision and replaces the portion of the skull that was removed.

After craniotomy:

  1. Patient is monitored closely in the intensive care unit or regular hospital room for several days.
  2. Patient may experience some pain and discomfort at the incision site.
  3. Patient may be prescribed pain medication and anti-seizure medication to manage symptoms.
  4. Patient may undergo physical therapy or rehabilitation to help with recovery.
  5. Follow-up appointments with the neurosurgeon are scheduled to monitor progress and adjust treatment as needed.

What to Ask Your Doctor

  1. What is the purpose of the craniotomy procedure?
  2. What are the risks and potential complications associated with craniotomy?
  3. How long will the recovery process be after the surgery?
  4. Will I need to undergo any additional treatments or therapies after the craniotomy?
  5. What type of anesthesia will be used during the surgery?
  6. How experienced is the surgical team in performing craniotomy procedures?
  7. Will there be any long-term side effects or changes in my cognitive function after the surgery?
  8. How will the surgery impact my daily activities and quality of life?
  9. What is the success rate of craniotomy for my specific condition?
  10. Are there any alternative treatment options to consider before undergoing craniotomy?

Reference

Authors: Vigren P, Eriksson M, Gauffin H, Duffau H, Milos P, Eek T, Dizdar N. Journal: Int J Neurosci. 2024 Dec;134(12):1624-1629. doi: 10.1080/00207454.2023.2279498. Epub 2023 Nov 15. PMID: 37929598