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The Egyptian Journal of Neurology, Psychiatry and Neurosurgery

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Open Access 01-12-2021 | Craniotomy | Research

Awake surgery for lesions near eloquent brain under scalp block and clinical monitoring: experience of single center with limited resources

Authors: Esam Abdelhameed, Mohamed Shebl Abdelghany, Hazem Abdelkhalek, Hytham Ibrahim Shokry Elatrozy

Published in: The Egyptian Journal of Neurology, Psychiatry and Neurosurgery | Issue 1/2021

Abstract

Background

Surgery of the brain tumors near eloquent areas carries the risk of either disabling neurological deficit or inadequate resection with bad prognosis in both situations. Awake surgery is the gold standard procedure for such lesions. However, it requires certain anesthetic drugs, advanced techniques, and trained teams that are not available in every neurosurgical institute. This work aims to evaluate safety, feasibility, and outcome of operating on patients with space occupying lesions near eloquent areas under scalp block being continuously examined by a neurologist through retrospective study of 20 cases with supratentorial lesions related to language or sensorimotor cortex.

Results

There were 12 males and 8 females with mean age 36.8 years. Forty percent of patients were presented by motor weakness. Tumors were related to motor cortex in 11 patients and to language areas in 9 patients. Mean operative time was 210 min. Gross or near total resection was achieved in 15cases, four cases had subtotal resection and biopsy only was done in 1 case. Two patients suffered from intraoperative seizures and conversion to general anesthesia was required in one patient.

Conclusion

Operating on tumors near eloquent brain areas under scalp block and continuous neurological examination during tumor resection proved to be effective in early detection and prevention of permanent major deficits especially in the developing countries with limited resources.

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Title: Awake surgery for lesions near eloquent brain under scalp block and clinical monitoring: experience of single center with limited resources
Authors: Esam Abdelhameed
Mohamed Shebl Abdelghany
Hazem Abdelkhalek
Hytham Ibrahim Shokry Elatrozy
Publication date: 01-12-2021
Publisher: Springer Berlin Heidelberg
Keyword: Craniotomy
Published in: The Egyptian Journal of Neurology, Psychiatry and Neurosurgery / Issue 1/2021
Electronic ISSN: 1687-8329
DOI: https://doi.org/10.1186/s41983-021-00333-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Awake surgery for lesions near eloquent brain under scalp block and clinical monitoring: experience of single center with limited resources

Abstract

Background

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Results

Conclusion

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