دورية أكاديمية
Awake Surgery for Brain Vascular Malformations and Moyamoya Disease.
| العنوان: | Awake Surgery for Brain Vascular Malformations and Moyamoya Disease. |
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| المؤلفون: | Aoun RJN; Department of Neurological Surgery, Neurovascular and Skullbase Program, Mayo Clinic, Phoenix, Arizona, USA; Precision Neuro-therapeutics Innovation Lab, Mayo Clinic, Phoenix, Arizona, USA; Neurosurgery Simulation and Innovation Lab, Mayo Clinic, Phoenix, Arizona, USA., Sattur MG; Department of Neurological Surgery, Neurovascular and Skullbase Program, Mayo Clinic, Phoenix, Arizona, USA., Krishna C; Department of Neurological Surgery, Neurovascular and Skullbase Program, Mayo Clinic, Phoenix, Arizona, USA., Gupta A; Department of Neurological Surgery, Neurovascular and Skullbase Program, Mayo Clinic, Phoenix, Arizona, USA; Precision Neuro-therapeutics Innovation Lab, Mayo Clinic, Phoenix, Arizona, USA; Neurosurgery Simulation and Innovation Lab, Mayo Clinic, Phoenix, Arizona, USA., Welz ME; Department of Neurological Surgery, Neurovascular and Skullbase Program, Mayo Clinic, Phoenix, Arizona, USA; Precision Neuro-therapeutics Innovation Lab, Mayo Clinic, Phoenix, Arizona, USA; Neurosurgery Simulation and Innovation Lab, Mayo Clinic, Phoenix, Arizona, USA., Nanney AD 3rd; Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA., Koht AH; Department of Anesthesiology, Northwestern University Memorial Hospital, Chicago, Illinois, USA., Tate MC; Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA., Noe KH; Department of Neurology, Mayo Clinic, Phoenix, Arizona, USA., Sirven JI; Department of Neurology, Mayo Clinic, Phoenix, Arizona, USA., Anderies BJ; Department of Neurological Surgery, Neurovascular and Skullbase Program, Mayo Clinic, Phoenix, Arizona, USA; Precision Neuro-therapeutics Innovation Lab, Mayo Clinic, Phoenix, Arizona, USA; Neurosurgery Simulation and Innovation Lab, Mayo Clinic, Phoenix, Arizona, USA., Bolton PB; Department of Anesthesiology, Mayo Clinic, Phoenix, Arizona, USA., Trentman TL; Department of Anesthesiology, Mayo Clinic, Phoenix, Arizona, USA., Zimmerman RS; Department of Neurological Surgery, Neurovascular and Skullbase Program, Mayo Clinic, Phoenix, Arizona, USA., Swanson KR; Department of Neurological Surgery, Neurovascular and Skullbase Program, Mayo Clinic, Phoenix, Arizona, USA., Bendok BR; Department of Neurological Surgery, Neurovascular and Skullbase Program, Mayo Clinic, Phoenix, Arizona, USA; Department of Otolaryngology, Mayo Clinic, Phoenix, Arizona, USA; Department of Radiology, Mayo Clinic, Phoenix, Arizona, USA; Precision Neuro-therapeutics Innovation Lab, Mayo Clinic, Phoenix, Arizona, USA; Neurosurgery Simulation and Innovation Lab, Mayo Clinic, Phoenix, Arizona, USA. Electronic address: Bendok.bernard@mayo.edu. |
| المصدر: | World neurosurgery [World Neurosurg] 2017 Sep; Vol. 105, pp. 659-671. Date of Electronic Publication: 2017 Apr 02. |
| نوع المنشور: | Case Reports; Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: United States NLM ID: 101528275 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1878-8769 (Electronic) Linking ISSN: 18788750 NLM ISO Abbreviation: World Neurosurg Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: New York : Elsevier |
| مواضيع طبية MeSH: | Wakefulness*, Central Nervous System Vascular Malformations/*surgery , Monitoring, Intraoperative/*methods , Moyamoya Disease/*surgery , Neurosurgical Procedures/*methods, Adult ; Central Nervous System Vascular Malformations/diagnostic imaging ; Female ; Humans ; Magnetic Resonance Imaging/methods ; Male ; Middle Aged ; Moyamoya Disease/diagnostic imaging ; Young Adult |
| مستخلص: | Objective: Although a significant amount of experience has accumulated for awake procedures for brain tumor, epilepsy, and carotid surgery, its utility for intracranial neurovascular indications remains largely undefined. Awake surgery for select neurovascular cases offers the advantage of precise brain mapping and robust neurologic monitoring during surgery for lesions in eloquent areas, avoidance of potential hemodynamic instability, and possible faster recovery. It also opens the window for perilesional epileptogenic tissue resection with potentially less risk for iatrogenic injury. Methods: Institutional review board approval was obtained for a retrospective review of awake surgeries for intracranial neurovascular indications over the past 36 months from a prospectively maintained quality database. We reviewed patients' clinical indications, clinical and imaging parameters, and postoperative outcomes. Results: Eight consecutive patients underwent 9 intracranial neurovascular awake procedures conducted by the senior author. A standardized "sedated-awake-sedated" protocol was used in all 8 patients. For the 2 patients with arteriovenous malformations and the 3 patients with cavernoma, awake brain surface and white matter mapping was performed before and during microsurgical resection. A neurological examination was obtained periodically throughout all 5 procedures. There were no intraoperative or perioperative complications. Hypotension was avoided during the 2 Moyamoya revascularization procedures in the patient with a history of labile blood pressure. Postoperative imaging confirmed complete arteriovenous malformation and cavernoma resections. No new neurologic deficits or new-onset seizures were noted on 3-month follow-up. Conclusions: Awake surgery appears to be safe for select patients with intracranial neurovascular pathologies. Potential advantages include greater safety, shorter length of stay, and reduced cost. (Copyright © 2017. Published by Elsevier Inc.) |
| فهرسة مساهمة: | Keywords: Arteriovenous malformation; Awake surgery; Cavernomas; Direct cortical stimulation; Moyamoya; Neurovascular surgery; fMRI |
| تواريخ الأحداث: | Date Created: 20170406 Date Completed: 20171004 Latest Revision: 20180209 |
| رمز التحديث: | 20240628 |
| DOI: | 10.1016/j.wneu.2017.03.121 |
| PMID: | 28377246 |
| قاعدة البيانات: | MEDLINE |
Full Text via ClinicalKey 
Full Text Finder | تدمد: | 1878-8769 |
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| DOI: | 10.1016/j.wneu.2017.03.121 |