Commentary on “Awake craniotomy with dexmedetomidine during resection of brain tumours located in eloquent regions”

Awake craniotomy and electrophysiological mapping for eloquent area tumours.

OBJECTIVE An awake craniotomy facilitates radical excision of eloquent area gliomas and ensures neural integrity during the excision. The study describes our experience with 67 consecutive awake craniotomies for the excision of such tumours. METHODS Sixty-seven patients with gliomas in or adjacent to eloquent areas were included in this study. The patient was awake during the procedure and in...

Initial Experience with Brain Mapping under Awake Craniotomy for Resection of Insular Gliomas of the Dominant Hemisphere

Background & Importance: Insular lobe is located at the depth of sylvian fissure and is hidden by frontal, temporal and parietal lobes in close vicinity of internal capsule and basal ganglia and adjacent to the speech centers in the dominant hemisphere. Thus, radical resection of insular gliomas can be even more difficult. Brain mapping techniques can be used to maximize the extent of...

Awake craniotomy under local anaesthesia and monitored conscious sedation for resection of brain tumours in eloquent cortex--outcomes in 20 patients.

INTRODUCTION Resection or even biopsy of an intra-axial mass lesion in close relationship to eloquent cortex carries a major risk of neurological deficit. We review the safety and effectiveness of craniotomy under local anaesthesia and monitored conscious sedation for resection of mass lesions involving eloquent cortex. MATERIALS AND METHODS We performed a 3-year retrospective review of patie...

Dexmedetomidine for awake craniotomy without laryngeal mask.

OBJECTIVE This paper reports the use of dexmedetomidine in three epileptic patients with cavernous angiomas that underwent awake surgery in order to map their speech areas. METHOD Loading dose of dexmedetomidine varied from 1 microg/Kg/h to 3 microg/Kg/h over 20 minutes and maintenance dose from 0.4 microg/Kg/h to 0.8 microg/Kg/h. RESULTS There was no occurrence of hemodynamic instability, ...

Commentary: Out-of-Body Experience during Awake Craniotomy