Kulikov A S, Kobyakov G L, Gavrilov A G, Lubnin A Yu
Burdenko Neurosurgery Institute, Moscow, Russia.
Zh Vopr Neirokhir Im N N Burdenko. 2015;79(6):15-21. doi: 10.17116/neiro201579615-21.
Awake craniotomy is recognized as method that can decrease the frequency of neurological complications after surgery for gliomas located near eloquent brain regions. Unfortunately good neurological outcome can't be ensured even by using of this technique. This paper discusses reasons and possible ways of prevention of such complications.
162 awake craniotomies were performed in our clinic.
152 of patients were discharged from the clinic with good outcome. In 10 (6%) cases sustained severe neurological deficit was noted. These complications were associated with anatomic or ischemic injury of subcortical pathways and internal capsule.
Awake craniotomy is effective instrument of brain language mapping and prevention of neurological deterioration. Severe neurological complications of awake craniotomy are associated with underestimate neurosurgical risks, especially in terms of blood vessel injury and depth of resection. The main way of prevention of such complications is meticulous planning of operation and adequate using of mapping facilities.
清醒开颅手术被认为是一种可降低位于脑功能区附近的胶质瘤手术后神经并发症发生率的方法。不幸的是，即使采用这种技术也无法确保良好的神经功能预后。本文讨论了此类并发症的原因及可能的预防方法。
我们诊所共进行了162例清醒开颅手术。
152例患者出院时预后良好。10例（6%）出现严重神经功能缺损。这些并发症与皮质下通路和内囊的解剖或缺血性损伤有关。
清醒开颅手术是脑语言定位和预防神经功能恶化的有效手段。清醒开颅手术的严重神经并发症与对神经外科风险的低估有关，尤其是在血管损伤和切除深度方面。预防此类并发症的主要方法是精心规划手术并充分利用定位设备。
