LIMITATIONS OF AWAKE CRANIOTOMY IN THE SURGERY OF BRAIN GLIOMAS. CASE REPORTS
Keywords:
awake craniotomy, cortical mapping, glioma of cerebral hemispheres.Abstract
Actuality. Awake craniotomy, a method that allows intraoperative cortical mapping and functional cognitive testing, has now become the method of choice for resection of brain gliomas, which are located in or nearby eloquent cerebral cortex. But the procedure requires a strict election of the patients in order to avoid various intraoperative complications.
Objective. Sharing our two cases from our experience of using awake craniotomy that where not successful due to some limitations.
Materials and methods: This work is based on the analysis of 2 cases from our practice of patients who underwent awake brain tumor surgery in our skull base department of the Republican Scientific Practical Center for Neurosurgery.
Results. We have analyzed the cases of our 2 patients, whom we have performed awake brain surgery but, due to some limitations were not successful. We have ruled out what kind of limitations can hinder to the success of the surgery.
Conclusion. The use of intraoperative cortical mapping and awake brain surgery facilitates to control speech as well as motor, sensory functions of the cerebral cortex. Mapping contributes to the best outcome of abovementioned functions in postoperative period. At the same time, careful patients selection is a fundamental success factor. To avoid unwanted intraoperative situations, a clear assessment of the mental status of the patients at the preoperative stage is crucial.
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