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Stauffer A, Tortora A, Marbacher S, Frey J, Gschwind M, Weinmann C, Gruber P, Berberat J, Luedi MM, Andereggen L. Refractory photophobia elicited during awake craniotomy for the resection of a temporal high-grade glioma. J Clin Anesth 2022; 78:110650. [PMID: 35030494 DOI: 10.1016/j.jclinane.2022.110650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/03/2022] [Accepted: 01/04/2022] [Indexed: 10/19/2022]
Affiliation(s)
| | - Angelo Tortora
- Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland
| | - Serge Marbacher
- Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland; Faculty of Medicine, University of Bern, Bern, Switzerland
| | - Julia Frey
- Neuropsychology Unit, Department of Neurology, Kantonsspital Aarau, Aarau, Switzerland
| | - Markus Gschwind
- Department of Neurology, Kantonsspital Aarau, Aarau, Switzerland
| | | | - Philipp Gruber
- Department of Neuroradiology, Kantonsspital Aarau, Aarau, Switzerland
| | - Jatta Berberat
- Department of Neuroradiology, Kantonsspital Aarau, Aarau, Switzerland
| | - Markus M Luedi
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Lukas Andereggen
- Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland; Faculty of Medicine, University of Bern, Bern, Switzerland.
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Curot J, Roux FE, Sol JC, Valton L, Pariente J, Barbeau EJ. Awake Craniotomy and Memory Induction Through Electrical Stimulation: Why Are Penfield's Findings Not Replicated in the Modern Era? Neurosurgery 2021; 87:E130-E137. [PMID: 31914177 DOI: 10.1093/neuros/nyz553] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 11/13/2019] [Indexed: 01/21/2023] Open
Abstract
From the 1930s through the early 1960s, Wilder Penfield12 collected a large number of memories induced by electrical brain stimulation (EBS) during awake craniotomy. As a result, he was a major contributor to several neuroscientific and neuropsychological concepts of long-term memory. His 1963 paper, which recorded all the cases of memories he induced in his operating room, remains a substantial point of reference in neuroscience in 2019, although some of his interpretations are now debatable. However, it is highly surprising that, since Penfield's12 reports, there has been no other surgical publication on memories induced during awake surgery. In this review, we explore this phenomenon and analyze some of the reasons that might explain it. We hypothesize that the main reasons for lack of subsequent reports are related to changes in operative procedures (ie, use of anesthetics, time constraints, and insufficient debriefings) and changes in EBS parameters, rather than to the sites that are stimulated, the pathology treated, or the tasks used. If reminiscences are still induced, they should be reported in detail to add valuable contributions to the understanding of long-term memory networks, especially memories that are difficult to reproduce in the laboratory, such as autobiographical memories.
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Affiliation(s)
- Jonathan Curot
- Department of Neurophysiological Explorations, Hôpital Pierre Paul Riquet, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.,Centre de Recherche Cerveau et Cognition CerCo, CNRS, UMR5549, Toulouse, France.,Centre de Recherche Cerveau et Cognition, Université de Toulouse, Université Paul Sabatier, Toulouse, France
| | - Franck-Emmanuel Roux
- Centre de Recherche Cerveau et Cognition CerCo, CNRS, UMR5549, Toulouse, France.,Centre de Recherche Cerveau et Cognition, Université de Toulouse, Université Paul Sabatier, Toulouse, France.,Department of Neurosurgery, Hôpital Pierre Paul Riquet, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Jean-Christophe Sol
- Department of Neurosurgery, Hôpital Pierre Paul Riquet, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.,INSERM, U1214, TONIC, Toulouse Mind and Brain Institute, Toulouse, France
| | - Luc Valton
- Department of Neurophysiological Explorations, Hôpital Pierre Paul Riquet, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.,INSERM, U1214, TONIC, Toulouse Mind and Brain Institute, Toulouse, France.,Centre de Recherche Cerveau et Cognition, Université de Toulouse, Université Paul Sabatier, Toulouse, France
| | - Jéremie Pariente
- Department of Cognitive Neurology, Hôpital Pierre Paul Riquet, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.,INSERM, U1214, TONIC, Toulouse Mind and Brain Institute, Toulouse, France
| | - Emmanuel J Barbeau
- Centre de Recherche Cerveau et Cognition CerCo, CNRS, UMR5549, Toulouse, France.,Centre de Recherche Cerveau et Cognition, Université de Toulouse, Université Paul Sabatier, Toulouse, France
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Ruis C. Monitoring cognition during awake brain surgery in adults: A systematic review. J Clin Exp Neuropsychol 2018; 40:1081-1104. [DOI: 10.1080/13803395.2018.1469602] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Carla Ruis
- Department of Neurology and Neurosurgery, University Medical Center Utrecht, Utrecht, The Netherlands
- Experimental Psychology, Utrecht University, Utrecht, The Netherlands
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Kelm A, Sollmann N, Ille S, Meyer B, Ringel F, Krieg SM. Resection of Gliomas with and without Neuropsychological Support during Awake Craniotomy-Effects on Surgery and Clinical Outcome. Front Oncol 2017; 7:176. [PMID: 28868255 PMCID: PMC5563316 DOI: 10.3389/fonc.2017.00176] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 08/02/2017] [Indexed: 01/14/2023] Open
Abstract
Background During awake craniotomy for tumor resection, a neuropsychologist (NP) is regarded as a highly valuable partner for neurosurgeons. However, some centers do not routinely involve an NP, and data to support the high influence of the NP on the perioperative course of patients are mostly lacking. Objective The aim of this study was to investigate whether there is a difference in clinical outcomes between patients who underwent awake craniotomy with and without the attendance of an NP. Methods Our analysis included 61 patients, all operated on for resection of a presumably language-eloquent glioma during an awake procedure. Of these 61 cases, 47 surgeries were done with neuropsychological support (NP group), whereas 14 surgeries were performed without an NP (non-NP group) due to a language barrier between the NP and the patient. For these patients, neuropsychological assessment was provided by a bilingual resident. Results Both groups were highly comparable regarding age, gender, preoperative language function, and tumor grades (glioma WHO grades 1–4). Gross total resection (GTR) was achieved more frequently in the NP group (NP vs. non-NP: 61.7 vs. 28.6%, P = 0.04), which also had shorter durations of surgery (NP vs. non-NP: 240.7 ± 45.7 vs. 286.6 ± 54.8 min, P < 0.01). Furthermore, the rate of unexpected tumor residuals (estimation of the intraoperative extent of resection vs. postoperative imaging) was lower in the NP group (NP vs. non-NP: 19.1 vs. 42.9%, P = 0.09), but no difference was observed in terms of permanent surgery-related language deterioration (NP vs. non-NP: 6.4 vs. 14.3%, P = 0.48). Conclusion We need professional neuropsychological evaluation during awake craniotomies for removal of presumably language-eloquent gliomas. Although these procedures are routinely carried out with an NP, this is one of the first studies to provide data supporting the NP’s crucial role. Despite the small group size, our study shows statistically significant results, with higher rates of GTR and shorter durations of surgery among patients of the NP group. Moreover, our data emphasize the common problem of language barriers between the surgical and neuropsychological team and patients requiring awake tumor resection.
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Affiliation(s)
- Anna Kelm
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Nico Sollmann
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Sebastian Ille
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Bernhard Meyer
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Florian Ringel
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Sandro M Krieg
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
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Freyschlag CF, Kerschbaumer J, Eisner W, Pinggera D, Brawanski KR, Petr O, Bauer M, Grams AE, Bodner T, Seiz M, Thomé C. Optical Neuronavigation without Rigid Head Fixation During Awake Surgery. World Neurosurg 2016; 97:669-673. [PMID: 27989983 DOI: 10.1016/j.wneu.2016.10.091] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 10/18/2016] [Accepted: 10/20/2016] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Optical neuronavigation without rigid pin fixation of the head may lead to inaccurate results because of the patient's movements during awake surgery. In this study, we report our results using a skull-mounted reference array for optical tracking in patients undergoing awake craniotomy for eloquent gliomas. METHODS Between March 2013 and December 2014, 18 consecutive patients (10 men, 8 women) with frontotemporal (n = 16) or frontoparietal (perirolandic; n = 2) lesions underwent awake craniotomy without rigid pin fixation. All patients had a skull-mounted reference array for optical tracking placed on the forehead. Accuracy of navigation was determined with pointer tip deviation measurements on superficial and bony anatomic structures. Good accuracy was defined as a tip deviation <2 mm. RESULTS Gross total resection (>98%) was achieved in 7 patients (38%); >90% of tumor was resected in 8 patients (44%). In 3 patients, only subtotal resection or biopsy was performed secondary to stimulation results. In all patients, good accuracy of the optical neuronavigation system could be demonstrated without intraoperative peculiarities or complications. The reference array had to be repositioned because of loosening in 1 patient. Neuronavigation could be reliably applied to support stimulation-based resection. CONCLUSIONS A skull-mounted reference array is a simple and safe method for optical neuronavigation tracking without rigid pin fixation of the patient's head.
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Affiliation(s)
| | | | - Wilhelm Eisner
- Department of Neurosurgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Daniel Pinggera
- Department of Neurosurgery, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Ondra Petr
- Department of Neurosurgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Marlies Bauer
- Department of Neurosurgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Astrid E Grams
- Department of Neuroradiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Thomas Bodner
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Marcel Seiz
- Department of Neurosurgery, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany
| | - Claudius Thomé
- Department of Neurosurgery, Medical University of Innsbruck, Innsbruck, Austria
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