Giannantonio Spena1, Elena Roca2,3, Francesco Guerrini4, Pier Paolo Panciani5, Lorenzo Stanzani6, Andrea Salmaggi6, Sabino Luzzi4, Marco Fontanella5. 1. Department of Neurosurgery, Alessandro Manzoni Hospital, Lecco, Italy. 2. Unit of Neurosurgery, Spedali Civili, University of Brescia, Piazzale Spedali Civili 1, Brescia, 25100, Italy. rocaelena@gmail.com. 3. Department of Neurosurgery, University of Milan, Milan, Italy. rocaelena@gmail.com. 4. Neurosurgery Unit, IRCCS Policlinico San Matteo, Pavia, Italy. 5. Unit of Neurosurgery, Spedali Civili, University of Brescia, Piazzale Spedali Civili 1, Brescia, 25100, Italy. 6. Department of Neuroscience, Alessandro Manzoni Hospital, Lecco, Italy.
Abstract
INTRODUCTION: During surgery for lesions in eloquent areas the goal is to achieve the widest resection possible, without loss of neurological function. Intraoperative seizures may lead to abandonment of the procedure or damages to the patient. Awareness regarding the predictors of IOS would help the surgeon. The aim of this retrospective study was to identify the factors associated with the occurrence of IOS in patients who underwent awake surgery for removal of gliomas in eloquent areas. METHODS: This was a retrospective analysis of prospectively collected data of 109 patients who underwent awake craniotomy between January 2010 and December 2017 for removal of gliomas. IOS were defined as tonic-clonic seizures or loss of consciousness resulting in communication difficulties with the patient occurring during cortical and subcortical mapping. RESULTS: A total of 109 patients were included in this study and IOS occurred in 9 (8.2%) patients. Demographic and clinical factors were comparable between patients with and without IOS. In the IOS group, 7 (77.8%) patients had seizures preoperatively and 4 (57.1%) were on more than one perioperative antiepileptic drugs (AED). CONCLUSIONS: The current series add some hints to the poorly studied IOS risk during awake surgery. The risk of IOS appears to be relatively higher in patients with anteriorly located tumors and in patients operated without intraoperative brain activity monitoring and different patterns of stimulation for language and sensory-motor mapping. Further studies are needed to clarify the role of intraoperative techniques.
INTRODUCTION: During surgery for lesions in eloquent areas the goal is to achieve the widest resection possible, without loss of neurological function. Intraoperative seizures may lead to abandonment of the procedure or damages to the patient. Awareness regarding the predictors of IOS would help the surgeon. The aim of this retrospective study was to identify the factors associated with the occurrence of IOS in patients who underwent awake surgery for removal of gliomas in eloquent areas. METHODS: This was a retrospective analysis of prospectively collected data of 109 patients who underwent awake craniotomy between January 2010 and December 2017 for removal of gliomas. IOS were defined as tonic-clonic seizures or loss of consciousness resulting in communication difficulties with the patient occurring during cortical and subcortical mapping. RESULTS: A total of 109 patients were included in this study and IOS occurred in 9 (8.2%) patients. Demographic and clinical factors were comparable between patients with and without IOS. In the IOS group, 7 (77.8%) patients had seizures preoperatively and 4 (57.1%) were on more than one perioperative antiepileptic drugs (AED). CONCLUSIONS: The current series add some hints to the poorly studied IOS risk during awake surgery. The risk of IOS appears to be relatively higher in patients with anteriorly located tumors and in patients operated without intraoperative brain activity monitoring and different patterns of stimulation for language and sensory-motor mapping. Further studies are needed to clarify the role of intraoperative techniques.
Authors: Marc Zanello; Bernhard Meyer; Megan Still; John R Goodden; Henry Colle; Christian Schichor; Lorenzo Bello; Michel Wager; Anja Smits; Bertil Rydenhag; Matthew Tate; Philippe Metellus; Philip De Witt Hamer; Giannantonio Spena; Laurent Capelle; Emmanuel Mandonnet; Santiago Gil Robles; Silvio Sarubbo; Juan Martino González; Denys Fontaine; Nicolas Reyns; Sandro M Krieg; Gilles Huberfeld; Maria Wostrack; David Colle; Erik Robert; Bonny Noens; Peter Muller; Natan Yusupov; Marco Rossi; Marco Conti Nibali; Costanza Papagno; Victoria Visser; Hans Baaijen; Lara Galbarritu; Franco Chioffi; Carlos Bucheli; Alexandre Roux; Edouard Dezamis; Hugues Duffau; Johan Pallud Journal: Seizure Date: 2019-03-28 Impact factor: 3.184
Authors: Kenji Ibayashi; Araceli R Cardenas; Hiroyuki Oya; Hiroto Kawasaki; Christopher K Kovach; Matthew A Howard; Michael A Long; Jeremy D W Greenlee Journal: World Neurosurg Date: 2020-12-08 Impact factor: 2.104
Authors: Gabriele Savioli; Iride Francesca Ceresa; Sarah Macedonio; Sebastiano Gerosa; Mirko Belliato; Giorgio Antonio Iotti; Sabino Luzzi; Mattia Del Maestro; Gianluca Mezzini; Alice Giotta Lucifero; Elvis Lafe; Anna Simoncelli; Federica Manzoni; Lorenzo Cobianchi; Mario Mosconi; Fabrizio Cuzzocrea; Francesco Benazzo; Giovanni Ricevuti; Maria Antonietta Bressan Journal: Medicina (Kaunas) Date: 2020-04-24 Impact factor: 2.430
Authors: Sabino Luzzi; Alberto Maria Crovace; Mattia Del Maestro; Alice Giotta Lucifero; Samer K Elbabaa; Benedetta Cinque; Paola Palumbo; Francesca Lombardi; Annamaria Cimini; Maria Grazia Cifone; Antonio Crovace; Renato Galzio Journal: Heliyon Date: 2019-11-26