Role of Awake Craniotomy in Surgeries for Gliomas in Eloquent Areas
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- Category: Vol. 83, September 2015
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Role of Awake Craniotomy in Surgeries for Gliomas in Eloquent Areas, MOHAMED FATHY, MUSTAFA M.W. KOTB, ALAA ABDFATTAH, OMAR EL FALAKY and WESSAM SAMIR
Abstract
Objective: The aim of this work is to evaluate the variable outcomes of surgical excision of gliomas in eloquent areas of the brain using awake craniotomy.
Methods: 12 patients having gliomas in eloquent areas of the brain were included in this study and were operated under awake craniotomy. Operative procedures included tumor debulking, subtotal resection, and gross total resection. Post-operatively, patients were evaluated and followed-up for their neurological integrity, deficits and outcome.
Results: The median age of presentation in this study was 38 years. There was 8 males (67%) and 4 females (33%). In this study the main presentation of patients was headache (100%), followed by seizures in 6 patients (50%), and followed by contra-lateral motor weakness in 2 patients (17%). The most commonly involved lobe was the frontal lobe where it was involved in 6 patients (50%), followed by the temporal lobe in 4 patients (33%), followed by the parietal lobe in 2 patients (17%). We achieved gross total resection in 2 patients (17%), tumor debulking in four patients (33%), and subtotal resection in six patients (50%). Postoperatively, 3 patients (25%) had new onset motor weakness, it was transient in two patients (17%) and permanent in one patient (8%). Out of the 2 patients presented with pre-operatively motor weakness, one patient (50%) had further deterioration of motor power. Regarding speech, one patient (8%) had new onset expressive dysphasia. Out of the patients four patients had excellent outcomes (33%), four patients (33%) had good outcomes, three patients (25%) had a fair outcome, and one patient (8%) had a poor outcome.
Conclusion: Awake craniotomy allows maximal tumor resection with minimizing the risk of permanent postoperative neurological deficits.