Clinical analysis of resection of deep brain lesions by using awake anesthesia and multiple positioning technology

Abstract

Objective To investigate the surgical safety and clinical efficacy of resection of deep brain lesions by using awake anesthesia and multiple positioning technology. Methods A retrospective analysis of clinical data and surgical treatments of 77 patients with deep brain lesions, admitted to our hospital from September 2013 and September 2014, was performed. Craniotomy was performed under general anesthesia, and then, awaking up of patient during surgery was achieved. Under awake state, the boundary of the lesions was mapped by neuroimage navigation technology, and language and movement functional areas were located using direct cortex evoked potential or cortical electrical stimulation. The deep brain lesions were removed according to anatomic-functional boundaries. Patients were followed up for 3 months. Results Intra-operative awaking up was successful in 74 patients. Language areas were identified in 8 patients, and movement functional areas were detected in 38 patients. Total resection was achieved in 51 patients, sub-total resection in 24 and 2 partial removals. Postoperative temporary movement barriers were noted in 10 patients and language barriers in 2 patients. Conclusion The deep brain lesions can be maximally removed by combined neuroimage navigation with cortical electrical stimulate under awake anesthesia, which can significantly protect the important brain functions and improve the quality of patients life after surgery. Key words: Deep brain lesion; Awake anesthesia; Neuroimage navigation; Cortical electrophysiological monitoring