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. 2015 Jul;20(3):248-52.
doi: 10.17712/nsj.2015.3.20140548.

Awake craniotomy. A patient`s perspective

Khalid M Bajunaid  1 , Abdulrazag M Ajlan
Affiliations

Awake craniotomy. A patient`s perspective

Khalid M Bajunaid et al. Neurosciences (Riyadh). 2015 Jul.

Abstract

Objective: To report the personal experiences of patients undergoing awake craniotomy for brain tumor resection.

Methods: We carried out a qualitative descriptive survey of patients` experiences with awake craniotomies for brain tumor resection. The survey was conducted through a standard questionnaire form after the patient was discharged from the hospital.

Results: Of the 9 patients who met the inclusion criteria and underwent awake craniotomy, 3 of those patients reported no recollection of the operation. Five patients had auditory recollections from the operation. Two-thirds (6/9) reported that they did not perceive pain. Five patients remembered the head clamp fixation, and 2 of those patients classified the pain from the clamp as moderate. None of the patients reported that the surgery was more difficult than anticipated.

Conclusion: Awake craniotomy for surgical resection of brain tumors was well tolerated by patients. Most patients reported that they do not recall feeling pain during the operation. However, we feel that further work and exploration are needed in order to achieve better control of pain and discomfort during these types of operations.

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Figures

Figure 1
Figure 1
Standardized questionnaire form used for the survey on a patient’s perspective of awake craniotomy.
Figure 2
Figure 2
Awake craniotomy A) diagram showing the areas injected with 0.5% marcaine with epinephrine before the skin incision (grey). The clamp fixation points are injected just prior to the head fixation. The sensory nerves and its dermatomal distribution are shown in the figure. B) Intraoperative setting for an awake craniotomy procedure.
Figure 3
Figure 3
Preoperative evaluation MRI A) Preoperative T1 MRI with gadolinium of a 65 year-old female who presented with left side hemiparesis (patient 9). B) Preoperative T2 MRI of a 28 year-old female who presented with dysphasia (patient 4). C) Preoperative T1 MRI with gadolinium for an 82 year-old female who presented with mild dysphasia and right upper extremity weakness (patient 5).
Figure 4
Figure 4
Postoperative evaluation of A) patient 9, B) patient 4, and C) patient 5 consecutively.
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