Awake craniotomy for glioblastoma in a 9‐year‐old child

Abstract

SummaryWe report the pre-operative preparation and anaesthetic management for resection of an intracerebral tumour during awake craniotomy in a 9-year-old boy. We believe this is the youngest patient reported to have undergone this procedure. The challenges of sedation and psychological care throughout the procedure are discussed. We conclude that the procedure can be performed safely and that it seems unacceptable to uphold an age restriction. We believe that it is the individual level of development of the child that determines suitability for this type of surgery.

Severe remifentanil-induced acute opioid tolerance following awake craniotomy in an adolescent

“…Numerous anesthetic management strategies for awake craniotomies in the pediatric population have been described [4][5][6][7]. Many of the techniques include a natural airway with a patient who is able to speak during the awake phase of the surgery.…”

Scalp Block for Burr Holle Evacuation of Subdural Hematoma: A Series of Seven Patients and Review of the Literature

“…In two reports of awake craniotomy in the literature that reported two children, aged 9 and 16 years, propofol was preferred to provide sedation [19,20]. However, scalp block was used in just one of these patients [20], and local anesthetic infiltration was preferred in the other patient [19]. The scalp block can be combined not only with awake craniotomy, but also with general anesthesia.…”

Pediatric Awake Craniotomy for Brain Lesions

“…Pasquet [1 ]proposed in 1953 that pediatric patients younger than 10 years of age would not tolerate craniotomy under local anesthesia. However, Klimek et al [2] performed awake craniotomy in a 9-year-old patient with glioblastoma and resected the tumor. This is the youngest known awake craniotomy case in the literature.…”

“…As this procedure is already difficult for adult patients, the management of pediatric cases is even more troublesome. The youngest patient treated with awake craniotomy reported in the literature was 9 years old and had a diagnosis of glioblastoma [2]. In this paper, we present perioperative procedures of tumor resection with awake craniotomy in 2 pediatric patients aged 12 and 15 years.…”