Our Summary

This study looks at a type of brain surgery called awake craniotomy (AC), where the patient is conscious for part of the surgery. The researchers examined 46 cases, including both adults and children, who had this surgery between 2011 and 2016. They wanted to see how the patients did before and after the surgery, including any complications and how well they recovered.

They found that while some patients experienced a temporary worsening of their neurological condition during surgery, most had fully recovered within a month. Even those who developed hemiplegia (paralysis on one side of the body) were able to move with help within 6 months. All patients had regained their language abilities to the level they were at before the surgery by the 1-month mark.

The researchers concluded that AC can be a safe and effective method of brain surgery, with very low rates of lasting neurological issues. However, they also highlighted the importance of good teamwork between the surgeon, anesthesiology team, and patient for successful outcomes.

FAQs

  1. What is an awake craniotomy and how does it work?
  2. What were the main findings of the study regarding patient recovery after an awake craniotomy?
  3. Why is teamwork between the surgeon, anesthesiology team, and patient important for successful outcomes in an awake craniotomy?

Doctor’s Tip

One helpful tip a doctor might tell a patient about craniotomy is to ensure they have a strong support system in place before and after the surgery. This can include family members, friends, or a caregiver who can assist with daily tasks and provide emotional support during the recovery process. It’s important for patients to follow their doctor’s post-operative instructions closely, including taking prescribed medications, attending follow-up appointments, and participating in any recommended rehabilitation programs. By taking these steps and having a strong support system in place, patients can increase their chances of a successful recovery following a craniotomy.

Suitable For

Patients who are typically recommended for craniotomy include those with brain tumors, arteriovenous malformations, aneurysms, traumatic brain injuries, epilepsy, and other neurological conditions. Patients who have failed conservative treatments or have tumors in critical areas of the brain may also be candidates for craniotomy. Additionally, patients who require biopsy or excision of brain lesions may undergo craniotomy. The decision to recommend craniotomy is made based on the specific diagnosis, location, size, and characteristics of the brain lesion, as well as the overall health and medical history of the patient.

Timeline

Before the craniotomy:

  • Patient undergoes pre-operative tests and assessments to determine if they are a suitable candidate for surgery.
  • Patient meets with their surgical team to discuss the procedure, risks, and potential outcomes.
  • Patient may need to stop certain medications or adjust their diet leading up to the surgery.
  • Patient may undergo imaging tests such as MRI or CT scans to help the surgeon plan the procedure.

During the craniotomy:

  • Patient is brought into the operating room and given anesthesia to induce sleep.
  • Surgeon makes an incision in the scalp and removes a piece of the skull to access the brain.
  • In an awake craniotomy, the patient may be awakened during the surgery to help the surgeon map out important areas of the brain and ensure they do not damage critical functions.
  • Surgeon removes the tumor or performs the necessary procedure on the brain.
  • Once the surgery is complete, the skull piece is replaced and the incision is closed.

After the craniotomy:

  • Patient is monitored closely in the recovery room for any immediate complications.
  • Patient may experience pain, swelling, or headaches in the days following the surgery.
  • Patient will need to stay in the hospital for a period of time for observation and recovery.
  • Patient may need physical therapy or rehabilitation to regain strength and function.
  • Follow-up appointments will be scheduled to monitor the patient’s progress and address any concerns.
  • Patient may need ongoing care and monitoring to ensure the best possible outcome.

What to Ask Your Doctor

  1. What specific condition or issue is prompting the need for a craniotomy?
  2. What are the risks and potential complications associated with a craniotomy in my case?
  3. How experienced is the surgical team in performing craniotomies, especially awake craniotomies?
  4. What is the expected recovery time and process following a craniotomy?
  5. Will I need any additional treatments or therapies after the surgery?
  6. How will my pain be managed during and after the surgery?
  7. Are there any long-term effects or risks associated with a craniotomy in my case?
  8. What steps can I take to prepare for the surgery and optimize my recovery?
  9. Are there any lifestyle changes or precautions I should take following the surgery?
  10. How frequently will I need follow-up appointments and monitoring after the surgery?

Reference

Authors: Akay A, Islekel S. Journal: Turk Neurosurg. 2018;28(2):186-192. doi: 10.5137/1019-5149.JTN.19391-16.1. PMID: 29099148