Our Summary

The research paper discusses a neurosurgical procedure called awake craniotomy. This procedure is used when a patient has a brain tumor located near areas of the brain responsible for language. The surgery is performed while the patient is awake to help identify and preserve these vital language areas.

The paper reviews current studies related to this topic and presents information on the anatomy of the brain, pre-surgery brain imaging techniques, monitoring of the brain’s electrical activity during surgery, and neuropsychological tests. It also discusses the strategies used during the surgery itself.

Awake craniotomy is a growing field and is aimed not only at preserving speech and motor functions during brain tumor surgery but also at improving our understanding of how speech functions in the brain.

FAQs

  1. What is an awake craniotomy and why is it performed?
  2. What are some of the pre-surgery procedures and monitoring techniques involved in an awake craniotomy?
  3. How does awake craniotomy contribute to our understanding of speech functions in the brain?

Doctor’s Tip

One helpful tip a doctor might tell a patient about craniotomy is to follow post-operative care instructions closely to ensure proper healing and recovery. This may include taking prescribed medications, avoiding strenuous activities, attending follow-up appointments, and contacting the doctor if any concerning symptoms develop. It is also important to communicate any changes in symptoms or concerns with the medical team to ensure the best possible outcome.

Suitable For

Patients who are typically recommended for awake craniotomy are those with brain tumors located near areas of the brain responsible for language or other vital functions. This includes patients with gliomas, meningiomas, or metastatic brain tumors. Additionally, patients who have epilepsy or other conditions that require precise mapping of brain function may also be recommended for awake craniotomy.

It is important for patients considering awake craniotomy to undergo thorough pre-operative evaluation to determine if they are suitable candidates for the procedure. This evaluation may include neurological exams, imaging studies, and neuropsychological testing to assess language and cognitive function. Additionally, patients should be informed about the risks and benefits of awake craniotomy and have a thorough discussion with their healthcare team about the procedure.

Overall, awake craniotomy is a specialized neurosurgical technique that is recommended for patients with brain tumors located near critical brain regions. It allows for precise mapping of brain function during surgery, which can help preserve important functions such as speech and motor skills.

Timeline

Before the craniotomy:

  • Patient undergoes pre-operative testing, including imaging studies to locate the tumor and vital brain areas
  • Patient may meet with a neuropsychologist for baseline cognitive testing
  • Patient is informed about the procedure and potential risks
  • Patient may be instructed on how to participate in language mapping tasks during surgery

During the craniotomy:

  • Patient receives local anesthesia to numb the scalp
  • Surgeon makes an incision in the scalp and removes a portion of the skull to access the brain
  • Patient is awake and responsive during the surgery, performing language tasks as instructed by the surgical team
  • Surgeon removes the tumor while preserving vital brain functions
  • Brain activity is continuously monitored to ensure no damage to critical areas

After the craniotomy:

  • Patient is monitored in the recovery room and may stay in the hospital for several days
  • Patient may experience temporary side effects such as headache, nausea, or weakness
  • Patient undergoes follow-up imaging to assess the success of the surgery
  • Patient may require rehabilitation or speech therapy to regain any lost functions
  • Patient undergoes post-operative neuropsychological testing to assess cognitive function

Overall, the goal of an awake craniotomy is to safely remove a brain tumor while preserving important brain functions. This procedure allows for a more precise and individualized approach to surgery, leading to better outcomes for the patient.

What to Ask Your Doctor

Some questions a patient should ask their doctor about craniotomy include:

  1. Why is an awake craniotomy being recommended for my brain tumor surgery?
  2. What are the risks and benefits of an awake craniotomy compared to a traditional craniotomy?
  3. How will my language and motor functions be monitored during the surgery?
  4. What imaging techniques will be used to identify and map out the areas of my brain responsible for language?
  5. How will my brain’s electrical activity be monitored during the surgery?
  6. What post-operative care and rehabilitation will be needed after an awake craniotomy?
  7. How will the surgery impact my speech and language abilities in the long term?
  8. Are there any alternative treatment options to an awake craniotomy for my brain tumor?
  9. What is the success rate of awake craniotomy for preserving speech and motor functions?
  10. Can you provide more information about the experience and expertise of the neurosurgeon who will be performing the awake craniotomy?

Reference

Authors: Kobyakov GL, Lubnin AY, Kulikov AS, Gavrilov AG, Goryaynov SA, Poddubskiy AA, Lodygina KS. Journal: Zh Vopr Neirokhir Im N N Burdenko. 2016;80(1):107-116. doi: 10.17116/neiro2016801107-116. PMID: 27186613