Awake craniotomy in neurosurgery: Shall we do it more often?

Okunlola, Abiodun Idowu; Babalola, Olakunle Fatai; Okunlola, Cecilia Kehinde; Akinmade, Akinola; Abiola, Paul Olukayode; Orewole, Tesleem Olayinka

doi:10.1016/j.inat.2020.100770

Cited by 13 publications

(20 citation statements)

References 23 publications

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“…Eighteen studies (94.7%) reported the primary analgesic and sedation used in AC. [22][23][24][25][26][27][28][29][30][31][32][33][34][36][37][38][39][40] Propofol/fentanyl combination was used for sedation/ analgesia in 10 studies (52.6%) 22,24,[26][27][28][29][30][31]36,37 (Supplementary Table 3, http://links.lww.com/NEU/D712). Sixteen studies (84.2%) provided information on operation time.…”

Section: Overview Of Literature Search Resultsmentioning

confidence: 99%

“…[34][35][36]38,40 Apart from 2 studies (10.5%) that had a mixture of adults and pediatric patients, 28,30 and 1 study (5.26%) that was on a child, 40 all other studies (84.2%) had adult patient populations. [22][23][24][25][26][27]29,[31][32][33][34][35][36][37][38][39] The youngest reported AC patient was 11 years old, 40 with the oldest being 92 years old, 33 demonstrating the accessibility of AC for a wide age range. Relative to adults undergoing operations, AC is less widely used in children, likely due to case complexity, a higher risk of postoperative neurocognitive deficits, and a lower frequency of lesions in eloquent areas 51,52 (Table 1).…”

Section: Awake Craniotomy In Adults and Pediatricsmentioning

confidence: 99%

“…4 Nine studies (47.4%) specified their lesion area. 22,26,28,29,32,34,[38][39][40] Four studies (21.1%) had motor area lesions, 29,32,34,40 whereas motor and language area lesions were reported in 4 other studies (21.1%) 22,28,38,39 (Supplementary Table 5, http://links.lww.com/NEU/D714).…”

Section: Intraoperative Description Of Acmentioning

confidence: 99%

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Awake Craniotomy in Africa: A Scoping Review of Literature and Proposed Solutions to Tackle Challenges

et al. 2023

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BACKGROUND: Awake craniotomy (AC) is a common neurosurgical procedure for the resection of lesions in eloquent brain areas, which has the advantage of avoiding general anesthesia to reduce associated complications and costs. A significant resource limitation in low- and middle-income countries constrains the usage of AC. OBJECTIVE: To review the published literature on AC in African countries, identify challenges, and propose pragmatic solutions by practicing neurosurgeons in Africa. METHODS: We conducted a scoping review under Preferred Reporting Items for Systematic Reviews and Meta-Analysis-Scoping Review guidelines across 3 databases (PubMed, Scopus, and Web of Science). English articles investigating AC in Africa were included. RESULTS: Nineteen studies consisting of 396 patients were included. Egypt was the most represented country with 8 studies (42.1%), followed by Nigeria with 6 records (31.6%). Glioma was the most common lesion type, corresponding to 120 of 396 patients (30.3%), followed by epilepsy in 71 patients (17.9%). Awake-awake-awake was the most common protocol used in 7 studies (36.8%). Sixteen studies (84.2%) contained adult patients. The youngest reported AC patient was 11 years old, whereas the oldest one was 92. Nine studies (47.4%) reported infrastructure limitations for performing AC, including the lack of funding, intraoperative monitoring equipment, imaging, medications, and limited human resources. CONCLUSION: Despite many constraints, AC is being safely performed in low-resource settings. International collaborations among centers are a move forward, but adequate resources and management are essential to make AC an accessible procedure in many more African neurosurgical centers.

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Section: Overview Of Literature Search Resultsmentioning

confidence: 99%

Section: Awake Craniotomy In Adults and Pediatricsmentioning

confidence: 99%

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Awake Craniotomy in Africa: A Scoping Review of Literature and Proposed Solutions to Tackle Challenges

et al. 2023

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“…Conventionally, a parasagittal tumor will require general anesthesia for surgical intervention but we successfully excised this parasagittal tumor through awake craniotomy protocol. [ 9 ] The prognosis depends on the histological grade of the tumor and extent of solid tumor resection.…”

Section: Discussionmentioning

confidence: 99%

“…[ 5 , 13 , 14 ] Surgery is the gold standard for symptomatic meningiomas including cystic meningioma, usually under general anesthesia; however, awake craniotomy is gaining more attention in modern neurosurgical practice. [ 9 ] The need for adjuvant management depends on the extent surgical excision and tumor biology.…”

Section: Introductionmentioning

confidence: 99%

Parasagittal cystic meningioma mimicking hemangioblastoma: A case report

Okunlola

Ibijola

Babalola

et al. 2021

Surgical Neurology International

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Background: Cystic meningioma is a rare variety with similar histological profiles like the solid tumors. It has been documented in both supratentorial and infratentorial compartments presenting radiologically as a large cyst with mural nodule mimicking hemangioblastoma. Case Description: We managed a middle-aged woman who presented with recurrent seizures and brain MRI revealed left frontal cystic parasagittal tumor with mural nodule. She had left frontal awake craniotomy and gross total tumor excision. Histology confirmed meningothelial meningioma. Conclusion: Cystic meningioma is rare but should be high in differentials of cystic intracranial tumor with dural based nodules. Awake craniotomy is possible for the excision of parasagittal tumor most especially when it is frontal in location.

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