Low Rate of Intraoperative Seizures During Awake Craniotomy in a Prospective Cohort with 374 Supratentorial Brain Lesions: Electrocorticography Is Not Mandatory.

摘要: Objective Awake craniotomy (AC) in brain lesions has allowed an improvement of both oncologic and functional results. However, intraoperative seizures (IOSs) were reported as a cause failure AC. Here, we analyze the incidence, risk factors, consequences IOSs prospective cohort 374 ACs without electrocorticography (ECoG). Methods We performed study including all patients who underwent AC for intra-axial supratentorial cerebral lesion from 2009-2014 our department. Occurrence IOS was analyzed with respect to medical epilepsy history, tumor characteristics, operative technique, postoperative outcomes. Results The comprised major incidence low-grade glioma (86%). Most (83%) had history before surgery (20% intractable seizures). Preoperative mean Karnofsky performance scale (KPS) score 91. occurred 13 (3.4%). All partial seizures, which quickly resolved by irrigation cold Ringer lactate. No procedure failed because IOS, rate aborted whatever nil. Mean stimulation current intensity cortical subcortical mapping 2.25 ± 0.6 mA. Presurgical refractory not associated higher IOS. Three months after surgery, no severe or disabling permanent worsening, even within group (mean KPS 93.7). Conclusions can be safely reproducibly achieved ECoG, low excellent results, preoperative epilepsy.