Our Summary

This research paper is about a study that was done on awake craniotomies, which are surgeries performed on the brain while the patient is awake. This method allows doctors to check the patient’s brain function during the operation, which can help reduce the risk of permanent damage and allow for a more complete removal of the problem area.

The study looked back at the first year of doing these surgeries in a non-university-affiliated hospital. They looked at how long the operations took, any complications that occurred, and the outcomes for the patients. They also sent out a survey to the patients to see how they felt about the surgery.

Over the course of the year, they performed 24 awake craniotomies on 22 patients. The surgeries were done to treat various types of brain tumors and other growths. On average, the surgeries took 205 minutes. Two surgeries were not successful because the patients had seizures during the operation, which made it difficult to test their brain function or get their cooperation.

About 29% of the patients had temporary problems with their brain function after surgery, and one patient had permanent issues. However, of the 18 patients who responded to the survey, only two said they were significantly scared during the surgery.

The researchers concluded that it is possible to introduce awake craniotomies in a non-university-affiliated hospital. The operation times and complication rates were reasonable, and the patients were generally satisfied with their experience.

FAQs

  1. What is the purpose of an awake craniotomy?
  2. What are the potential complications of an awake craniotomy?
  3. How do patients generally perceive their experience during an awake craniotomy?

Doctor’s Tip

A helpful tip a doctor might tell a patient about craniotomy is to follow all pre-operative instructions provided by the medical team, such as fasting before surgery and avoiding certain medications. It is also important to ask any questions or voice any concerns you may have before the procedure to ensure you are well-informed and prepared. Additionally, following post-operative care instructions, such as taking prescribed medications and attending follow-up appointments, is crucial for a successful recovery.

Suitable For

Patients with brain lesions in or near eloquent brain regions, such as low-grade/high-grade gliomas, cavernomas, and metastases, are typically recommended for awake craniotomy. This procedure allows neurosurgeons to assess neurologic functions of patients intraoperatively, reducing the risk of permanent neurologic deficits and increasing the extent of tumor resection. Additionally, patients who are able to cooperate and tolerate the awake state during surgery are suitable candidates for awake craniotomy.

Timeline

Before a craniotomy:

  • Patient meets with neurosurgeon to discuss the procedure and potential risks and benefits
  • Patient undergoes preoperative testing such as imaging scans and blood tests
  • Patient may meet with anesthesiologist to discuss anesthesia options
  • Patient may be instructed to stop taking certain medications prior to surgery
  • Patient may be asked to fast for a certain amount of time before surgery

After a craniotomy:

  • Patient is monitored closely in the recovery room for any complications
  • Patient may be transferred to the intensive care unit for further monitoring
  • Patient may experience pain and discomfort at the incision site
  • Patient may be given pain medication and antibiotics to prevent infection
  • Patient may undergo physical therapy to help with recovery
  • Patient may have follow-up appointments with the neurosurgeon to monitor progress and discuss further treatment options.

What to Ask Your Doctor

  1. What is the purpose of a craniotomy in my case?
  2. What are the potential risks and complications associated with a craniotomy?
  3. Why is an awake craniotomy being recommended for me?
  4. How will my neurologic functions be assessed during the awake craniotomy?
  5. How long will the operation take?
  6. What is the expected recovery time after a craniotomy?
  7. What are the chances of experiencing permanent neurologic deficits after the procedure?
  8. How experienced are you in performing awake craniotomies?
  9. Will I be able to communicate with the surgical team during the procedure?
  10. What other treatment options are available for my condition?

Reference

Authors: Joswig H, Bratelj D, Brunner T, Jacomet A, Hildebrandt G, Surbeck W. Journal: World Neurosurg. 2016 Jun;90:588-596.e2. doi: 10.1016/j.wneu.2016.02.051. Epub 2016 Feb 18. PMID: 26898498