![]() ![]() 7 Shorter hospital stays realized with awake craniotomy translate into decreased hospital expenses. A recent review of 951 patients, some of whom underwent awake craniotomy (n = 411) and others standard craniotomy (n = 540), documented much shorter hospital stays and quick functional recovery within the group treated with awake craniotomy. 4,6 The availability of intraoperative mapping and functional delineation provides reasonable confidence with tumor resection.Īwake craniotomy has additional advantages over standard craniotomy with general anesthesia. 4-6 Awake craniotomies undoubtedly achieve superior extent of resection in eloquent regions when compared to standard craniotomies that employ general anesthesia for similar lesions. Accordingly, awake craniotomies are often associated with great functional outcomes. Similarly, patients are tested functionally during tumor resection, which is often terminated if at any point the patient develops deficits related to the area of eloquence. 1-3 Hence, activation of motor activity or disruption of speech during electrical stimulation strongly suggests that the stimulated area is critical and necessary for functional preservation. Local anesthesia in the form of a scalp block with mild intermittent sedation is often sufficient.ĭuring the operation, intraoperative mapping is often performed and remains the gold standard for delineation of the relationship of tumor to eloquent cortex. Patients are typically conscious during most of the procedure, which is often carried out in the absence of general anesthesia. ![]() Awake craniotomies are traditionally reserved for, but not limited to, tumors involving the primary motor ( Figure 1) and speech ( Figure 2) areas.
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