Anaesthetic technique during awake craniotomy. Case report and literature review

Abstract

Introduction: Awake craniotomy for neurostimulation can be managed with different anaesthetic techniques, ranging from local anaesthesia or local anaesthesia with sedation to intermittent general anaesthesia. Materials and methods: We present the case of a 56-year-old female who was diagnosed with a frontal astrocytoma which required surgical resection. Her magnetic resonance imaging study showed a space-occupying lesion in her left frontotemporal region, which was exerting a mass effect on the midline structures. Anatomically, the tumour involved the language area and motor tracts. It was therefore decided to perform craniotomy with the patient awake during the procedure, to allow intraoperative cortical mapping in order to preserve the language and motor functions. Results: This case was managed with a scalp nerve block as local anaesthesia plus intravenous sedation without airway instrumentation. We reviewed the literature about patient management during awake craniotomy.

Keywords

• Craniotomy
• Anaesthetics
• Astrocytoma
• Cerebral cortex