Search results for "awake surgery"
showing 8 items of 8 documents
Intraoperative brain mapping of language, cognitive functions, and social cognition in awake surgery of low-grade gliomas located in the right non-do…
2020
Abstract Objective The aim of our study was to evaluate the usefulness of cortical-subcortical intraoperative brain mapping (ioBM) in resective awake surgery of low-grade gliomas (LGG) of the right non-dominant hemisphere (RndH). It was estimated how ioBM may affect both the extent of resection and postoperative outcome of language, spatial cognition, social cognition, and executive functions including attention and working memory. Patients and Methods : Fifteen patients that underwent ioBM in resective awake surgery of LGG located on the RndH, were included. A cohort of 15 patients with the same tumour location operated under general anaesthesia without brain mapping was used as control. S…
Intraoperative brain mapping during awake surgery in symptomatic supratentorial cavernomas.
2021
Abstract Background Complete resection of symptomatic supratentorial cavernoma (SCA) and removal of the surrounding gliotic area is recommended to minimize the risk of persistent seizures or (re)bleeding. Surgery of SCA located in an eloquent area, can carry out severe postoperative neurological morbidity. We report a study aimed to assess feasibility, extent of resection and outcome after surgical removal of CA by cortico-subcortical intraoperative brain stimulation (ioBS) in the awake patient. Methods Six patients diagnosed of symptomatic SCA located on an eloquent area and operated on while awake under local anaesthesia ioBS, were included. Preoperative planning included neuropsychologic…
Risk Stratification by nrTMS Language Mapping
2017
Resecting language-eloquent brain lesions is a major challenge in neurosurgery since we need to weight the risks of worsening the patients’ functional integrity and achieving a maximum safe resection. Although relevant functional brain structures can be identified intraoperatively by direct cortical mapping during awake surgery, a preoperative identification of functional anatomy is recommended in order to gauge surgical risks, evaluate resectability, plan the surgical approach, and identify potential starting points for intraoperative stimulation mapping.
Manual Reaction Times and Brain Dynamics after 'Awake Surgery' of Slow-Growing Tumours Invading the Parietal Area. A Case Report.
2012
International audience; PRIMARY OBJECTIVES: Awake surgeries of slow-growing tumours invading the brain and guided by direct electrical stimulation induce major brain reorganizations accompanied with slight impairments post-operatively. In most cases, these deficits are so slight after a few days that they are often not detectable on classical neuropsychological evaluations. Consequently, this study investigated whether simple visuo-manual reaction time paradigms would sign some level of functional asymmetries between both hemispheres. Importantly, the visual stimulus was located in the saggital plane in order to limit attentional biases and to focus mainly on the inter-hemispheric asymmetry…
Brain mapping as helpful tool in brain glioma surgical treatment—Toward the “perfect surgery”?
2018
Gliomas are the most common primary malignant brain tumours in adults, representing nearly 80%, with poor prognosis in their high-grade forms. Several variables positively affect the prognosis of patients with high-grade glioma: young age, tumour location, radiological features, recurrence, and the opportunity to perform post-operative adjuvant therapy. Low-grade gliomas are slow-growing brain neoplasms of adolescence and young-adulthood, preferentially involving functional areas, particularly the eloquent ones. It has been demonstrated that early surgery and higher extent rate ensure overall longer survival time regardless of tumour grading, but nowadays, functional preservation that is as…
Awake Surgery: Skills of Neurosurgeon Matter but Those of Patient Too. How to Optimize Functional Brain Mapping by Improving Per-Operatory Testing?
2011
International audience; It is now possible to perform resections of slowgrowing tumors in awake patients. Using direct electrical stimulation (DES), real-time functional mapping of the brain can be used to prevent the resection of essential areas near the tumor. For now, simple clinical tests are performed on conscious patients and combined with DES in order to discriminate functional and non-functional areas invaded by the tumors. In this work we try to develop a simple device based on a simple technology to better quantify the performances of the patients during the surgery itself and give a real-time feedback to the neurosurgeon that will help to further guide the surgery by improving th…
Disrupting the right pars opercularis with electrical stimulation frees the song: case report
2015
International audience; The authors report the first case of a strikingly unusual speech impairment evoked by intraoperative electrostimulation in a 36-year-old right-handed patient, a well-trained singer, who underwent awake surgery for a right fronto-temporoinsular low-grade glioma. Functionally disrupting the pars opercularis of the right inferior frontal gyrus led the patient to automatically switch from a speaking to a singing mode of language production. Given the central role of the right pars opercularis in the inhibitory control network, the authors propose that this finding may be interpreted as possible evidence for a competitive and independent neurocognitive subnetwork devoted …
"Awake Surgery" of Slow-Growing Tumors and Cortical Excitability Measured by EEG Recordings. Preliminary Results
2012
International audience; To investigate interhemispheric imbalance following "awake surgeries" of slow-growing tumors we recorded EEG in a visuo-manual RT paradigm. Increase of cortical excitability within the ipsilesional hemisphere was signed by increased ERPs amplitude for two patients. The cortical excitability in the lesioned hemisphere may be increased to maintain performances and cerebral plasticity.