Awake Craniotomy

2021 ◽  
Author(s):  
Dennis J. McNicholl
Keyword(s):  
Patient Outcome ◽  
Awake Craniotomy ◽  
Functional Neurosurgery ◽  
Deep Brain Stimulator ◽  
Modern Times ◽  
Awake State ◽  
Eloquent Cortex ◽  
And Training ◽  
Regional Anesthetic ◽  
Deep Brain

Prior to the advent of anesthesia, performing surgical procedures on patients in the awake state was the order of the day. In modern times, especially with the continued advancement and safety of anesthesia, such a practice of performing surgery on a patient in the awake state might appear unnecessary, and perhaps even medieval. However, this practice still does intentionally occur for a subset of neurosurgery patients. This unique dimension of the procedure places special demands on the anesthesiologist’s knowledge base, skill and training in order to produce a successful patient outcome. This chapter delves into salient aspects of patient selection, operating room setup, monitoring and communication considerations, pharmacologic regimens, regional anesthetic options and a thorough list of complications for which to be prepared. This review contains 5 figures, 5 tables, and 69 references. Keywords: awake craniotomy, functional neurosurgery, eloquent cortex, awake-asleep-awake, electrocorticography, epilepsy, deep brain stimulator, dexmedetomidine, intraoperative seizure

Awake Craniotomy for Tumour, Epilepsy, and Functional Neurosurgery

2019 ◽  
pp. 235-244
Author(s):  
Lashmi Venkatraghavan ◽  
Pirjo Manninen
Keyword(s):  
Epilepsy Surgery ◽  
Brain Function ◽  
Anaesthetic Management ◽  
Awake Craniotomy ◽  
Epileptic Focus ◽  
Awake Patient ◽  
Functional Neurosurgery ◽  
Deep Brain Stimulator ◽  
Deep Brain

An awake craniotomy for tumour and epilepsy surgery allows for the mapping of eloquent brain function to minimize its injury and/or for the localization of an epileptic focus. The insertion of deep brain stimulators for the treatment of functional neurosurgical disorders is also frequently performed with an awake patient. The role of the anaesthetist is important in order to have a comfortable and cooperative patient, for the use of appropriate sedation to allow for mapping, and careful vigilance to rapidly diagnose and treat any complication. This chapter discusses the overall rationale for, and the anaesthetic management of, patients undergoing awake craniotomy for tumours, epilepsy surgery, or deep brain stimulator placement.

scholarly journals Technical nuances to minimize common complications of deep brain stimulation

2017 ◽  
Vol 42 (videosuppl2) ◽  
pp. V2
Author(s):  
Paul House
Keyword(s):  
Deep Brain Stimulation ◽  
Surgical Technique ◽  
Brain Stimulation ◽  
Deep Brain Stimulator ◽  
Link Type ◽  
Prospective Trials ◽  
Skin Erosion ◽  
Deep Brain

The implantation of deep brain stimulator electrodes is associated with infrequent complications. These complications are consistent across prospective trials and include infection, skin erosion, hemorrhage, and lead misplacement. Nuances of surgical technique can be used to minimize the risk of these commonly noted complications. Several of these technical nuances are highlighted in this video submission.The video can be found here: https://youtu.be/GL09W9p013g.

Ventral Intermediate Thalamic Stimulation for Monoclonal Gammopathy-Associated Tremor: Case Report

Neurosurgery ◽  
2011 ◽  
Vol 68 (5) ◽  
pp. E1464-E1467 ◽  
Author(s):  
Donald C. Shields ◽  
Alice W. Flaherty ◽  
Emad N. Eskandar ◽  
Ziv M. Williams
Keyword(s):  
Daily Living ◽  
Monoclonal Gammopathy ◽  
Clinical Presentation ◽  
Sensory Loss ◽  
Intention Tremor ◽  
Deep Brain Stimulator ◽  
Thalamic Stimulation ◽  
Central Nervous System Dysfunction ◽  
Stimulation Parameters ◽  
Deep Brain

Abstract BACKGROUND AND IMPORTANCE: Peripheral and central sensory loss are often associated with significant tremor or sensory ataxia, which can be highly refractory to medical therapy. CLINICAL PRESENTATION: We present the case of a 67-year-old man with progressive and debilitating intention tremor from monoclonal gammopathy-associated peripheral neuropathy. The patient was implanted with bilateral thalamic deep brain stimulator electrodes under microelectrode guidance. Following optimization of stimulation parameters, the patient's appendicular tremor and gait improved, as did his general activities of daily living. CONCLUSION: These initial findings suggest that deep brain stimulation may benefit not only tremor presumed to originate from central nervous system dysfunction, but also tremor originating peripherally from neuropathy-related sensory loss.

Patient with a Deep Brain Stimulator

2020 ◽  
pp. 33-43
Author(s):  
Rudy Garza ◽  
Cory Jones ◽  
Maxim S. Eckmann
Keyword(s):  
Deep Brain Stimulator ◽  
Deep Brain

scholarly journals Generalized Dystonia Treated With Deep Brain Stimulator: An Institutional Single Surgeon Experience

Cureus ◽  
2020 ◽  
Author(s):  
Hammad Ghanchi ◽  
Jacob E Bernstein ◽  
Taha M Taka ◽  
Tye Patchana ◽  
Samir Kashyap ◽  
...  
Keyword(s):  
Deep Brain Stimulator ◽  
Surgeon Experience ◽  
Generalized Dystonia ◽  
Deep Brain

scholarly journals Implanted deep brain stimulator and 1.0-Tesla magnetic resonance imaging

2006 ◽  
Vol 24 (6) ◽  
pp. 1409-1412 ◽  
Author(s):  
Norbert Kovacs ◽  
Ferenc Nagy ◽  
Ferenc Kover ◽  
Adam Feldmann ◽  
Carlos Llumiguano ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Resonance Imaging ◽  
Deep Brain Stimulator ◽  
Deep Brain
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