Outcome of Awake Craniotomy at a Tertiary Care Hospital

Abstract

Objective: To evaluate the outcomes of awake craniotomy, in terms of complications and linguistic consequences at a tertiary care Hospital. Methodology: A prospective cohort study was done at department of Neurosurgery of PIMS Islamabad, from June 2023 to March 2023. Patients aged 18 years or above, both genders, diagnoses with brain tumors (both low and high-grade gliomas) and patients who already scheduled for Awake Craniotomy as per indications and Hospital protocols were included. Following surgery, all patients were moved to the intensive care unit for overnight assessment. During surgery, the operative time was recorded. Post-surgery, patients were monitored for neurological deficits, seizures, brain swelling, hospital stay and linguistic outcomes in terms of good, average and poor. All the relevant information was entered and analyzed via SPSS version 26. Results: Overall average age of the patients was 47.17+5.11 years, and their mean BMI was 29.12+2.96 kg/m2. Males were 16(40.0%) and females were 24 (60.0%). None of the patients found with neurological deficits or seizures, while brain swelling was observed in 23 patients (57.5%). Linguistic outcomes were uniformly positive, with all 40 patients (100%) reporting good outcomes. Mean operative time was 5.06 ± 0.80 hours, the mean Glasgow Coma Scale (GCS) score was 13.35 ± 1.20, and the average hospital stay was 6.32+1.84 days. Furthermore the brain swelling was statistically significant according to gender and operative time (p->0.05), while it was significantly high among patients with Grade II (Oligodendrogliomas) and with grade IV as pert he WHO grading (p-0.024). Conclusion: The awake craniotomy observed to be a reliable and easily tolerated method for brain tumor removal. Individuals who underwent this treatment reported no substantial neurological abnormalities or seizures, and almost all of the cases showed good linguistic outcomes.