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Awake glioma surgery: technical evolution and nuances.

Andrew J Gogos1, Jacob S Young2, Ramin A Morshed2

  • 1Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA. andrew.gogos@ucsf.edu.

Journal of Neuro-Oncology
|April 10, 2020
PubMed
Summary

Awake craniotomy is a key technique for maximizing glioma resection, improving patient survival. This method safely preserves neurological function and has become the standard for brain tumors near critical areas.

Keywords:
Awake craniotomyGliomaMotor mappingSpeech mapping

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Area of Science:

  • Neurosurgery
  • Oncology
  • Neuroscience

Background:

  • Maximal extent of resection in glioma surgery correlates with improved patient survival.
  • Awake craniotomy (AC) was developed to enhance tumor resection while preserving neurological function.

Purpose of the Study:

  • To review the evolution, indications, techniques, and outcomes of AC for glioma resection.
  • To detail a preferred AC technique and evaluate its efficacy.

Main Methods:

  • Comprehensive literature review of AC for glioma.
  • Detailed description of surgical technique and functional testing paradigms.

Main Results:

  • AC has become an essential tool for glioma resection, with many previous contraindications now manageable.
  • The technique allows for maximal safe resection, with refined mapping methods leading to low complication rates.

Conclusions:

  • Awake craniotomy with mapping is the gold standard for maximizing resection of tumors near eloquent brain areas.
  • The technique is associated with excellent functional and oncological outcomes and a very low complication rate.