Matthieu Delion1, Aram Terminassian2, Thierry Lehousse2, Ghislaine Aubin3, Jean Malka4, Sylvie N'Guyen5, Philippe Mercier6, Philippe Menei7. 1. Department of Neurosurgery, Angers Teaching Hospital, Angers, France; Anatomy Laboratory, Medical Faculty, University of Angers, LUNAM, Angers, France. Electronic address: matthieudelion@yahoo.com. 2. Department of Anesthesiology, Angers Teaching Hospital, Angers, France. 3. Department of Neuropsychology, Angers Teaching Hospital, Angers, France. 4. Department of Child Psychiatry, Angers Teaching Hospital, Angers, France. 5. Department of Pediatric Neurology, Angers Teaching Hospital, Angers, France. 6. Department of Neurosurgery, Angers Teaching Hospital, Angers, France; Anatomy Laboratory, Medical Faculty, University of Angers, LUNAM, Angers, France. 7. Department of Neurosurgery, Angers Teaching Hospital, Angers, France.
Abstract
BACKGROUND: In the pediatric population, awake craniotomy began to be used for the resection of brain tumor located close to eloquent areas. Some specificities must be taken into account to adapt this method to children. OBJECTIVE: The aim of this clinical study is to not only confirm the feasibility of awake craniotomy and language brain mapping in the pediatric population but also identify the specificities and necessary adaptations of the procedure. METHODS: Six children aged 11 to 16 were operated on while awake under local anesthesia with language brain mapping for supratentorial brain lesions (tumor and cavernoma). The preoperative planning comprised functional magnetic resonance imaging (MRI) and neuropsychologic and psychologic assessment. The specific preoperative preparation is clearly explained including hypnosis conditioning and psychiatric evaluation. The success of the procedure was based on the ability to perform the language brain mapping and the tumor removal without putting the patient to sleep. We investigated the pediatric specificities, psychological experience, and neuropsychologic follow-up. RESULTS: The children experienced little anxiety, probably in large part due to the use of hypnosis. We succeeded in doing the cortical-subcortical mapping and removing the tumor without putting the patient to sleep in all cases. The psychological experience was good, and the neuropsychologic follow-up showed a favorable evolution. CONCLUSIONS: Preoperative preparation and hypnosis in children seemed important for performing awake craniotomy and contributing language brain mapping with the best possible psychological experience. The pediatrics specificities are discussed.
BACKGROUND: In the pediatric population, awake craniotomy began to be used for the resection of brain tumor located close to eloquent areas. Some specificities must be taken into account to adapt this method to children. OBJECTIVE: The aim of this clinical study is to not only confirm the feasibility of awake craniotomy and language brain mapping in the pediatric population but also identify the specificities and necessary adaptations of the procedure. METHODS: Six children aged 11 to 16 were operated on while awake under local anesthesia with language brain mapping for supratentorial brain lesions (tumor and cavernoma). The preoperative planning comprised functional magnetic resonance imaging (MRI) and neuropsychologic and psychologic assessment. The specific preoperative preparation is clearly explained including hypnosis conditioning and psychiatric evaluation. The success of the procedure was based on the ability to perform the language brain mapping and the tumor removal without putting the patient to sleep. We investigated the pediatric specificities, psychological experience, and neuropsychologic follow-up. RESULTS: The children experienced little anxiety, probably in large part due to the use of hypnosis. We succeeded in doing the cortical-subcortical mapping and removing the tumor without putting the patient to sleep in all cases. The psychological experience was good, and the neuropsychologic follow-up showed a favorable evolution. CONCLUSIONS: Preoperative preparation and hypnosis in children seemed important for performing awake craniotomy and contributing language brain mapping with the best possible psychological experience. The pediatrics specificities are discussed.
Authors: Elise Riquin; Pierre Martin; Philippe Duverger; Philippe Menei; Matthieu Delion Journal: Childs Nerv Syst Date: 2017-06-03 Impact factor: 1.475
Authors: Anna Lorenzen; Samuel Groeschel; Ulrike Ernemann; Marko Wilke; Martin U Schuhmann Journal: Childs Nerv Syst Date: 2018-05-25 Impact factor: 1.475