Our Summary

This research paper looks at the occurrence of seizures during awake brain surgeries (also known as Awake Craniotomies or AC). These types of surgeries have potential advantages compared to those performed under general anesthesia, but one major concern is the risk of a seizure during surgery. The researchers examined various scientific articles and studies to understand how often seizures happen during these surgeries.

They found that, on average, seizures occurred in about 8% of all awake brain surgeries. For patients with a type of brain cancer known as glioma, the seizure rate was also 8%. For patients with low-grade brain conditions, the seizure rate was slightly higher at 10%. They also found that seizures occurred early on in 11% of surgeries, and later on in 35% of surgeries.

Despite these findings, the researchers concluded that awake brain surgeries are a safe technique with a relatively low risk of seizures during surgery. However, they also pointed out that there were very few high-quality controlled trials available for review, and they recommend more of these types of studies to gather more evidence.

FAQs

  1. What is the general intraoperative seizure rate for patients undergoing awake craniotomies?
  2. What is the intraoperative seizure rate for glioma patients undergoing awake craniotomies?
  3. Are awake craniotomies considered a safe technique in terms of intraoperative seizure occurrence?

Doctor’s Tip

One helpful tip a doctor might tell a patient about craniotomy is to discuss the risk of intraoperative seizures with their healthcare provider before the surgery. It is important for patients to be aware of the possibility of seizures during the procedure and to understand how they will be managed if they occur. Additionally, patients should follow their healthcare provider’s instructions for post-operative care to minimize the risk of complications, including seizures, after the surgery.

Suitable For

Patients with brain tumors, such as gliomas, and low grade tumors are typically recommended for craniotomy. Other patients who may benefit from craniotomy include those with epilepsy, traumatic brain injury, arteriovenous malformations, and other neurological conditions that require surgical intervention. It is important for patients and their healthcare providers to discuss the risks and benefits of craniotomy to determine if it is the best treatment option for their specific condition.

Timeline

Before a craniotomy:

  1. Patient undergoes initial consultation with a neurosurgeon to discuss the need for surgery.
  2. Pre-operative tests such as MRI, CT scan, and blood work are done to assess the patient’s condition.
  3. Patient may need to stop taking certain medications or follow a specific diet before surgery.
  4. Patient receives anesthesia before the surgery begins.
  5. During the surgery, the patient’s head is secured in a fixed position and a small incision is made in the scalp to access the brain.

After a craniotomy:

  1. Patient is monitored closely in the intensive care unit (ICU) immediately after surgery.
  2. Patient may experience headaches, nausea, or dizziness in the days following surgery.
  3. Physical therapy and rehabilitation may be necessary to regain strength and motor skills.
  4. Follow-up appointments with the neurosurgeon are scheduled to monitor recovery and address any concerns.
  5. Patient may need to take medication to prevent seizures or manage pain.
  6. Long-term follow-up care is important to monitor for any potential complications or recurrence of the condition.

What to Ask Your Doctor

  1. What is the likelihood of experiencing an intraoperative seizure during a craniotomy procedure?
  2. What are the potential risk factors that could increase the risk of experiencing a seizure during the procedure?
  3. How is an intraoperative seizure typically managed and treated during a craniotomy?
  4. Are there any specific precautions or measures that can be taken to reduce the risk of experiencing a seizure during the procedure?
  5. What is the difference in seizure rates between awake craniotomies and those performed under general anesthesia?
  6. Are there any long-term consequences or implications of experiencing a seizure during a craniotomy procedure?
  7. How does the presence of a brain tumor, such as a glioma, impact the likelihood of experiencing a seizure during a craniotomy?
  8. Are there any specific medications or interventions that can be used to prevent or minimize the risk of intraoperative seizures during a craniotomy?
  9. How does the timing of a seizure during a craniotomy (early vs. late) impact the overall outcome and recovery of the patient?
  10. Are there any additional resources or support services available for patients who may be concerned about the risk of experiencing a seizure during a craniotomy procedure?

Reference

Authors: Yuan Y, Peizhi Z, Xiang W, Yanhui L, Ruofei L, Shu J, Qing M. Journal: J Neurosurg Sci. 2019 Jun;63(3):301-307. doi: 10.23736/S0390-5616.16.03880-7. Epub 2016 Nov 25. PMID: 27886157