Related Experiment Video
Updated: Jul 24, 2026
11:58
Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
Published on: August 11, 2015
15.5K
Awake Craniotomy for Eloquent Brain Arteriovenous Malformations: A Systematic Review and Individual Patient Data
Gabriel Semione1, Gustavo de Oliveira Almeida2, Henrique Laurent Lepine3
1Department of Medicine, University of West of Santa Catarina, Joaçaba, Santa Catarina, Brazil.
World Neurosurgery
|December 26, 2024
Summary
Awake craniotomy (AC) for brain arteriovenous malformations (AVMs) in eloquent areas shows an 88% total resection rate. While initial neurological deficits occur in 20%, they decrease by follow-up, suggesting AC is a viable option.
Area of Science:
- Neurosurgery
- Neurology
- Medical Imaging
Background:
- Arteriovenous malformations (AVMs) in eloquent brain areas present a high risk of neurological damage.
- Awake craniotomy (AC) is established for gliomas but its role in AVMs requires further clarification.
Purpose of the Study:
- To systematically evaluate the efficacy and safety of awake craniotomy (AC) for treating arteriovenous malformations (AVMs) located in eloquent brain regions.
- To provide a comprehensive analysis of surgical outcomes, including resection rates and neurological deficits.
Main Methods:
- A systematic review and individual patient data meta-analysis was conducted adhering to PRISMA guidelines.
- Literature searches across PubMed, Embase, and Web of Science identified relevant studies including case reports, series, cohorts, and trials.
- Single proportion analysis was used to pool data from 20 studies involving 287 patients.
Main Results:
- Total resection was achieved in 88% of patients (95% CI: 81%-95%), with subtotal resection in nearly 12%.
- Postoperative neurological deficits were observed in 20% (95% CI: 13%-28%), decreasing to 6% (95% CI: 3%-9%) at follow-up.
- The mean hospital stay was short, averaging 4.13 days (95% CI: 3.61-4.66).
Conclusions:
- Awake craniotomy (AC) demonstrates promising outcomes for treating eloquent AVMs.
- While initial neurological deficits are noted, they significantly improve by follow-up.
- The procedure offers a favorable safety profile with a short hospitalization, supporting its consideration for eloquent AVMs.
