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Awake Craniotomy in Patients With Language Deficits: A Retrospective Cohort Study in 48 Patients
Suzanne L Hartung1, Irene M C Huenges Wajer1,2, Martine J E van Zandvoort1,3
1Department of Neurology and Neurosurgery, University Medical Center Utrecht, Utrecht , the Netherlands.
Background And Objectives:
This retrospective cohort study reviewed the feasibility and applicability of awake surgery for glioma in patients with clinically relevant preoperative language deficits, specifically focusing on intraoperative language monitoring and its impact on postoperative language outcomes.
Methods:
Group and individual analyses were conducted to compare preoperative and postoperative language deficits. In addition, an overview of intraoperative tests was provided, and an evaluation of the monitoring process was performed.
Results:
In 100% of patients with significant (z score ≤ -1 SD) preoperative language deficits (N = 48), language tasks could be performed during awake surgery. In 90% of these cases, functional boundaries for language function were found during surgery.
Conclusion:
This study confirms the feasibility and applicability of monitoring language functions during awake brain surgery when preoperative language deficits are present. Both low-grade and high-grade glioma patients show an overall stable performance on a language comprehension test and an improved performance on a language production test 3 to 6 months after surgery and, therefore, seemed to benefit from cognitive monitoring.
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