Awake craniotomy for glioblastoma in a 9-year-old child
M Klimek1, S J C Verbrugge, S Roubos
1Department of Anaesthesiology, Erasmus MC, University Medical Centre, Dr Molewaterplein 40, 3015 GD Rotterdam, the Netherlands.
Insights
Awake craniotomy for brain tumor resection is safe in children, even in the very young. A 9-year-old boy underwent the procedure, highlighting that developmental readiness, not age, determines suitability for this surgery.
Area of Science:
- Neurosurgery
- Pediatric Anesthesia
- Neuro-oncology
Background:
- Intracerebral tumors in children often require surgical resection.
- Awake craniotomy is a technique used to maximize tumor resection while preserving neurological function.
- Pediatric patients present unique challenges for anesthetic management and psychological support during complex procedures.
Observation:
- A 9-year-old boy underwent successful resection of an intracerebral tumor using awake craniotomy.
- This represents the youngest reported patient to undergo this procedure.
- The anesthetic management and pre-operative preparation were specifically tailored to the child's needs.
Findings:
- The procedure was performed safely with effective sedation and psychological care.
- The successful outcome in this young patient challenges traditional age-based restrictions for awake craniotomy.
- Individual developmental maturity, rather than chronological age, appears to be the critical factor for suitability.
Implications:
- Awake craniotomy can be considered for pediatric patients with intracerebral tumors, regardless of age, if developmentally appropriate.
- This approach may improve surgical outcomes and reduce the need for repeat procedures in young patients.
- Further research into developmental assessment for suitability in pediatric awake craniotomy is warranted.
Abstract:
We report the pre-operative preparation and anaesthetic management for resection of an intracerebral tumour during awake craniotomy in a 9-year-old boy. We believe this is the youngest patient reported to have undergone this procedure. The challenges of sedation and psychological care throughout the procedure are discussed. We conclude that the procedure can be performed safely and that it seems unacceptable to uphold an age restriction. We believe that it is the individual level of development of the child that determines suitability for this type of surgery.
