Anesthetic care during awake craniotomy in a pediatric patients

Cortical mapping has demonstrated a wide variability in the location of areas controlling speech, memory, motor and sensory function. These regions of the cortex, often referred to as eloquent cortex, can be near areas of epileptic foci or pathologic lesions, making the surgical resection of these lesions difficult. Optimal assessment of eloquent cortex function during a craniotomy often requires an awake and cooperative patient, making the anesthetic for these procedures challenging. We present a 13-year-old girl who required an awake craniotomy during tumor resection. Previous reports regarding the performance of an awake craniotomy in pediatric-aged patients are reviewed.