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01-02-2020 | Post-Traumatic Stress Disorder | Original Article

Psychological aspects of awake brain surgery in children—interests and risks

Authors: Ludivine Huguet, Laura-Nanna Lohkamp, Pierre-Aurelien Beuriat, Michel Desmurget, Lionel Bapteste, Alexandru Szathmari, Carmine Mottolese, Federico Di Rocco

Published in: Child's Nervous System | Issue 2/2020

Abstract

Awake brain surgery (ABS) in children remains a subject of controversial debate for the potential psychological limitations that are related to this type of procedure. However, the tolerance and benefits of ABS in adults advocate for increased application of ABS in children. In this study, we report the psychological assessment, evaluation algorithm, and outcome of pediatric patients, who underwent ABS for surgical treatment of lesions in eloquent areas. Psychological selection criteria and the specifications of psychological support are described. A retrospective review and analysis of psychological assessment and psychological outcome of pediatric patients, who underwent ABS between 2005 and 2018 at the Department of pediatric neurosurgery, University of Lyon, France, was performed. Long-term psychological outcomes are reported. ABS was proposed to 18 children aged between 9 and 17 years and their families. After psychological evaluation of the individual patient and their familial surrounding, five boys and 12 girls (n = 17) were accounted eligible for ABS. They underwent asleep-awake-asleep brain surgery with intraoperative testing. In 16 cases, ABS could be performed as planned. Psychological alterations were postoperatively observed in 3 patients, symptoms of a post-traumatic stress disorder in 1 patient. The precise preoperative evaluation of the risk-benefit ratio in children plays a crucial role in anticipating a good psychological outcome. Professional psychological preparation and support of the child and his or her family are the key elements for successful completion of ABS.

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Title: Psychological aspects of awake brain surgery in children—interests and risks
Authors: Ludivine Huguet
Laura-Nanna Lohkamp
Pierre-Aurelien Beuriat
Michel Desmurget
Lionel Bapteste
Alexandru Szathmari
Carmine Mottolese
Federico Di Rocco
Publication date: 01-02-2020
Publisher: Springer Berlin Heidelberg
Keyword: Post-Traumatic Stress Disorder
Published in: Child's Nervous System / Issue 2/2020
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-019-04308-8

At a glance: The STEP trials

Springer Medicine

Psychological aspects of awake brain surgery in children—interests and risks

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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