BACKGROUND During awake craniotomies, patients may either be awake for the entire duration of the surgical intervention (awake-awake-awake craniotomy, AAA) or initially sedated (asleep-awake-asleep craniotomy, SAS). OBJECTIVE To examine whether prior sedation in SAS may restrict brain mapping, we conducted neuropsychological tests in patients by means of a standardized anesthetic regimen comp...

As a promising noninvasive imaging technique, functional MRI (fMRI) has been extensively adopted as a functional localization procedure for surgical planning. However, the information provided by preoperative fMRI (pre-fMRI) is hampered by the brain deformation that is secondary to surgical procedures. Therefore, intraoperative fMRI (i-fMRI) becomes a potential alternative that can compensate f...

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...

Awake craniotomy Brain neoplasm Patient experience Phenomenology Qualitative research methods Intraoperative mapping is a well-established and safe technique to maximize the excision of tumors involving the eloquent cortex while minimizing neurological damage. Although different techniques are used, very little has been documented about how the patients feel, what they think about, or how they ...

Our anesthetic technique proposed for awake craniotomy is the monitored anesthesia care (MAC) technique, with patient in sedation throughout intervention. protocol involves analgo-sedation through administration of dexmedetomidine and remifentanil a continuous intravenous infusion, allowing to be sedated comfort, but contactable spontaneously breathing. Pre-surgery, pre-medicated intramuscular ...

There are two main approaches to intraoperative monitoring in neurosurgery. One approach is related to fluorescent phenomena and the other is related to oscillatory neuronal activity. We developed novel techniques to visualize blood flow (BF) conditions in real time, based on indocyanine green videography (ICG-VG) and the electrophysiological phenomenon of high gamma activity (HGA). We investig...