Experience of awake craniotomy in a child (clinical case)
O. N. Pulkina,
D. V. Nizolin,
Zh. Zh. Sholahov,
A. A. Zhaigalov,
A. V. Kim,
G. N. Kasenova,
O. O. Shmeleva https://doi.org/10.24884/2078-5658-2024-21-3-93-98
Abstract
The objective was to demonstrate the possibility of performing awake craniotomy in a child.
Materials and methods. The 9-year-old child with a dysembrioplastic neuroepithelial tumor in the left temporal lobe was planned and performed awake craniotomy. During awakening, the child performed a naming test, object designation tests, word repetition and spontaneous speech, and Luria’s test.
Results. During psychological tests and intraoperative neuromonitoring, it was possible to successfully identify the speech zone and motor areas of the face, which helped to safely remove brain formation without complications. This clinical case was also interesting because the child’s native language was Kazakh, so an interpreter was presented during the intraoperative awakening.
Conclusions. The case demonstrates the possibility of performing awake craniotomy in a child, which depends not only on the somatic and psychological state, but also on the professionalism of the operating team, including surgeons, anesthesiologists, neurophysiologist, neuropsychologist and a large number of nursing staff who are able to clearly interact with each other.
About the Authors
O. N. Pulkina
Saint-Petersburg Research Center of Phthisiopulmonology
Russian Federation
Russian Federation
Pulkina Olga N., Anesthesiologist and Intensivist, Head of the Department of Anesthesiology and Intensive Care № 3 (for children)
Аuthor ID: 946144
32, Politechnicheskaya str., St. Petersburg, 194021
D. V. Nizolin
Almazov National Medical Research Centre
Russian Federation
Russian Federation
Nizolin Dmitry V., Neurosurgeon
Аuthor ID: 1069793
2, Akkuratova str., Saint Petersburg, 197341
Zh. Zh. Sholahov
Children’s City Clinical Hospital № 2, Almaty
Kazakhstan
Kazakhstan
Sholahov Zhandos Zh., Anesthesiologist and Intensivist, Head of the Department of Anesthesiology and Intensive Care for children
54, Altynsarina str., Almaty, 050000
A. A. Zhaigalov
Children’s City Clinical Hospital № 2, Almaty
Kazakhstan
Kazakhstan
Zhaigalov Azamat A., Neurosurgeon
54, Altynsarina str., Almaty, 050000
A. V. Kim
Almazov National Medical Research Centre
Russian Federation
Russian Federation
Kim Alexandr V., Neurosurgeon, Head of the Neurosurgical Department for Children
2, Akkuratova str., Saint Petersburg, 197341
G. N. Kasenova
Children’s City Clinical Hospital № 2, Almaty
Kazakhstan
Kazakhstan
Kasenova Gulnura N., Neurologist and Neurophysiologist
54, Altynsarina str., Almaty, 050000
O. O. Shmeleva
Almazov National Medical Research Centre
Russian Federation
Russian Federation
Shmeleva Olga O., Neuropsychologist of the Department for Children with Neurosurgical Pathology
2, Akkuratova str., Saint Petersburg, 197341
References
1. Kobyakov G.L., Lubnin A.Y., Kulikov A.S., Gavrilov A.G. Craniotomy in consciousness. Questions of neurosurgery named after N.N. Burdenko, 2016, vol. 80, no. 1, pp. 107–116. (In Russ.) DOI: 10.17116/neiro2016801107-116.
2. Penkova I.A., Novikova A.I. Anesthesiological aspects of craniotomy in consciousness (literary review). Russian Neurosurgical Journal named after A. L. Polenov, 2016, vol. 8, no. 3, pp. 41–45. (In Russ.)
3. Akay A., Ruksen M., Cetin H.Y. et al. Pediatric awake craniotomy for brain lesions. Pediatr Neurosurg, 2016, vol. 51, no. 2, pp. 103–108. DOI: 10.1159/000442988.
4. Bello L., Gallucci M., Fava M. et al. Intraoperative subcortical language tract mapping guides surgical removal of gliomas involving speech areas. Neurosurgery, 2007, vol. 60, pp. 67–80. DOI: 10.1227/01.NEU.0000249206. 58601.DE.
5. Balogun J.A., Khan O.H., Taylor M. et al. Pediatric awake craniotomy and intra-operative stimulation mapping. Journal of Clinical Neuroscience, 2014, vol. 21, pp. 1891–1894.
6. Berger M.S., Kincaid J., Ojemann G.A. et al. Brain mapping techniques to maximize resection, safety, and seizure control in children with brain tumors. Neurosurgery, 1989, vol. 25, pp. 786–792. DOI: 10.1097/00006123-198911000-00015.
7. Chowdhyry T., Gray K., Sharma M. et al. Brain cancer progression:a retrospective multicenter comparison of awake craniotomy versus general anesthesia in high-grade glioma recection. J. Neurosurg. Anesthesiol, 2022, vol. 34, pp. 392–400. DOI: 10.1097/00000000000000778.
8. Delion M., Terminassian A., Lehousse T. et al. Specificities of awake craniotomy and brain mapping in children for resection of supratentorial tumors in the language area. World Neurosurg, 2015, vol. 84, pp. 1645–1652. DOI: 10.1016/j.wneu.2015.06.073.
9. Girvin J. Neurosurgical considerations and general methods for craniotomy under local anesthesia. Int Anesthesiol Clin, 1986, vol. 24, no. 3, pp. 89–114. DOI: 10.1097\00004311-198602430-00010.
10. Ojemann S.G., Berger M.S., Lettich E. et al. Localization of language function in children: results of electrical stimulation mapping. J Neurosurg, 2003, vol. 98, pp. 465–470. DOI: 10.3171/jns.2003.98.3.0465.
Review
For citations:
Pulkina O.N., Nizolin D.V., Sholahov Zh.Zh., Zhaigalov A.A., Kim A.V., Kasenova G.N., Shmeleva O.O. Experience of awake craniotomy in a child (clinical case). Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2024;21(3):93-98. (In Russ.) https://doi.org/10.24884/2078-5658-2024-21-3-93-98
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