Specificities of Awake Craniotomy and Brain Mapping in Children for Resection of Supratentorial Tumors in the Language Area
| Autor: | Ghislaine Aubin, Philippe Mercier, Sylvie Nguyen, Thierry Lehousse, Aram Terminassian, Jean Malka, Matthieu Delion, Philippe Menei |
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| Rok vydání: | 2015 |
| Předmět: |
Male
Hypnosis medicine.medical_specialty Neuronavigation Adolescent medicine.medical_treatment Brain tumor Supratentorial region Anxiety Neuropsychological Tests Brain mapping Monitoring Intraoperative medicine Humans Wakefulness Child Craniotomy Brain Mapping medicine.diagnostic_test business.industry Neuropsychology Supratentorial Neoplasms medicine.disease Magnetic Resonance Imaging Broca Area Surgery medicine.anatomical_structure Feasibility Studies Female Neurology (clinical) Radiology Functional magnetic resonance imaging business |
| Zdroj: | World neurosurgery. 84(6) |
| ISSN: | 1878-8769 |
| Popis: | Background In the pediatric population, awake craniotomy began to be used for the resection of brain tumor located close to eloquent areas. Some specificities must be taken into account to adapt this method to children. Objective The aim of this clinical study is to not only confirm the feasibility of awake craniotomy and language brain mapping in the pediatric population but also identify the specificities and necessary adaptations of the procedure. Methods Six children aged 11 to 16 were operated on while awake under local anesthesia with language brain mapping for supratentorial brain lesions (tumor and cavernoma). The preoperative planning comprised functional magnetic resonance imaging (MRI) and neuropsychologic and psychologic assessment. The specific preoperative preparation is clearly explained including hypnosis conditioning and psychiatric evaluation. The success of the procedure was based on the ability to perform the language brain mapping and the tumor removal without putting the patient to sleep. We investigated the pediatric specificities, psychological experience, and neuropsychologic follow-up. Results The children experienced little anxiety, probably in large part due to the use of hypnosis. We succeeded in doing the cortical-subcortical mapping and removing the tumor without putting the patient to sleep in all cases. The psychological experience was good, and the neuropsychologic follow-up showed a favorable evolution. Conclusions Preoperative preparation and hypnosis in children seemed important for performing awake craniotomy and contributing language brain mapping with the best possible psychological experience. The pediatrics specificities are discussed. |
| Databáze: | OpenAIRE |
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