Resection of eloquent brain area lesion under all-course awake anesthesia: technical notes and initial results
Wang Guoliang
Bai Hongmin
He Huan
Zhou Sijie
Li Tiandong
Tu Weifeng
Wang Weimin
Abstract：Objective To explore the surgical method and clinical significance of eloquent brain area lesion resection using all-course awake craniotomy under monitored anesthesia care without artificial airway.Methods Forty-seven patients with eloquent brain area lesion obtained maximal safe resection using all-course awake craniotomy under monitored anesthesia care without artificial airway.Scalp nerve block,incision and dural infiltration anesthesia were performed in all the patients.The lesions were localized by neuronavigation and (or) intra-operative ultrasound,and the functional cortex and sub-cortical structures were figured out by cortical direct electrical stimulation (DES).Results All the patients received safe and reliable monitored anesthesia care during the over-all operative procedures.Total lesion resection was achieved in 30 patients (63.8％),subtotal resection in 11 (23.4％) and partial resection in 6 (12.8％).The new transient neurological deficits occurred in 28 patients (59.6％) after the operation,of whom 26 returned to baseline nerve function within 1 month,only 2 left severe neurological deficits.One patient suffered severe paralysis due to infarction of the corona radiata,another deteriorated due to hydrocephalus and spinal cord metastasis after radiotherapy at the later stage.Conclusions All-course awake craniotomy under monitored anesthesia care without artificial airway can avoid the risks of increasing the intracranial pressure and so on during pulling out the laryngeal mask in traditional awake craniotomy (asleep-awake-asleep).The patients may be awaked at any time and cooperates well in the whole surgical process.All-course awake craniotomy might be a new method in ensuring maximal safe resection and optimal functional preservation for patients with lesion in the eloquent brain area.
Keywords：eloquent brain areamonitored anesthesia careawakeall-coursedirect electrical stimulation
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 385-388 )