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Review
. 2025 Apr;35(4):270-276.
doi: 10.1111/pan.15075. Epub 2025 Feb 1.

Pediatric Awake Craniotomy: An Educational Review

Maria Nabil Henry  1   2 , Maryam N Shahin  3 , Ian Stevens  3 , Jessica Calvert  4 , Dana Dharmakaya Colgan  5 , Michael Vega  6 , Kelly Collins  3
Affiliations
Review

Pediatric Awake Craniotomy: An Educational Review

Maria Nabil Henry et al. Paediatr Anaesth. 2025 Apr.

Abstract

Background: Awake craniotomies with functional cortical mapping are performed to minimize post-operative deficits from the resection of lesions adjacent to eloquent cortex. The procedure is well-established in the adult patient population and is increasingly applied to well-selected pediatric patients. A review of recent literature demonstrated that the most commonly reported anesthetic techniques were "asleep-awake-asleep" protocols that relied on propofol, remifentanil, or fentanyl.

Main article: This educational review discusses the unique challenges that face the anesthesiology and neurosurgical teams when working with the pediatric population. To further illustrate pediatric-specific considerations, a case of a 9-year-old boy who underwent a resection of a large left peri-rolandic ependymoma is presented, including his multidisciplinary pre-operative, intra-operative, and post-operative care.

Conclusion: Awake craniotomies can safely be performed in the pediatric population with appropriate patient selection, planning, and a multi-disciplinary approach.

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References

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