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Feasibility of awake craniotomy for brain tumours in children
Mujtaba Khalil1, Izza Tahir1, Ahmer Baig1
1Section of Neurosurgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan.
Insights
Awake craniotomy (AC) offers improved outcomes for brain tumor removal near critical areas in adults. While less common in children, successful AC in select older pediatric patients requires careful preparation and a team approach.
Area of Science:
- Neurosurgery
- Pediatric Oncology
- Neuroscience
Background:
- Awake craniotomy (AC) is a standard procedure for adult brain tumor resection near eloquent brain regions, enhancing patient outcomes and minimizing complications.
- The application of AC in pediatric neurosurgery is less established, though some studies indicate potential benefits in older children.
Purpose of the Study:
- To review the current literature and clinical considerations for performing awake craniotomy (AC) in pediatric patients.
- To highlight the factors contributing to successful AC in children, focusing on patient selection and preparation.
Main Methods:
- Literature review of studies reporting on awake craniotomy in pediatric populations.
- Analysis of case series and expert opinions on the feasibility and outcomes of AC in children.
Main Results:
- Awake craniotomy has demonstrated positive results in a carefully selected group of older pediatric patients.
- Key factors for success include patient cooperation, extensive pre-operative preparation, and a multidisciplinary team approach.
Conclusions:
- Awake craniotomy is a viable option for select pediatric cases involving tumors near eloquent brain areas.
- Successful implementation in children hinges on meticulous planning, patient selection, and comprehensive multidisciplinary care.
Abstract:
Awake craniotomy (AC) is routinely performed in adult patients for tumours near eloquent areas of the brain. It improves outcomes and reduces complications. However, its use is limited in children. However, several authors have reported good results of AC in a highly selective group of relatively older children. Fundamental to the success of AC is a co-operative child and thorough pre-operative preparation with a truly multidisciplinary approach.
