Abstract
ObjectiveTo determine the frequency and consequences of intra- and postoperative adverse events in awake craniotomy for intrinsic supratentorial brain tumors. Despite the growing prevalence of awake craniotomy intra- and postoperative, adverse events related to this surgery are poorly discussed.MethodsWe studied 25 patients undergoing awake craniotomy with maximum safe resection of intrinsic supratentorial brain tumors in the awake-asleep-awake protocol.ResultsSurgery-related inconveniences occurred in 23 patients (92%), while postoperative adverse events were observed in 17 cases (68%). Seven patients suffered from more than one postoperative complication. The most common surgery-related inconvenience was intraoperative hypertension (8 cases, 32%), followed by discomfort (7 cases, 28%), pain during surgery (5 cases, 20%), and tachycardia (3 cases, 12%). The most common postoperative adverse event was a new language deficit that occurred in 10 cases (40%) and remained permanent in one case (4%). Motor deficits occurred in 36% of cases and were permanent in one case (1%). Seizures were observed in 4 cases (16%) intra- and in 2 cases (8%) postoperatively. Seizures appeared more frequently in patients with multilobar insular-involving gliomas and in patients without prophylactic antiepileptic drug therapy.ConclusionsSurgery-related inconveniences and postoperative adverse events occur in most awake craniotomies. The most common intraoperative adverse event is hypertension, pain, and tachycardia. The most frequent postoperative adverse events are new language deficits and new motor deficits.
Highlights
Awake craniotomy (AC) with cortical and subcortical brain mapping has become a standard method in the treatment of intrinsic brain tumors located in eloquent brain areas [1]
We analyzed the adverse events observed during and after awake craniotomy for intrinsic brain tumors according to our own experience
We would like to stress the need for analysis and prevention of adverse events during and after awake surgery for brain tumors
Summary
Awake craniotomy (AC) with cortical and subcortical brain mapping has become a standard method in the treatment of intrinsic brain tumors located in eloquent brain areas [1]. There is a growing body of evidence that awake craniotomy is an effective method for treatment of gliomas promoting a Department of Neurosurgery and Neurotraumatology, Jagiellonian University Medical College, Jakubowskiego 2 Street, 30-688 Kraków, Poland. Jagiellonian University Medical College, Kraków, Poland 3 Department of Anesthesiology, 5th Military Hospital in Krakow, Krakow, Poland higher extent of resection, a lower incidence of neurological complications, and ensuring better overall survival while dealing with language and motor locations [2, 3]. When compared with surgery under general anesthesia, awake craniotomy for eloquent brain tumors ensures better onco-functional balance [6]. There is a need for identification of intra- and postoperative complications of awake surgery. The intra and postoperative complications may be related to surgical and anesthesiological factors.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
