Abstract
Both awake craniotomy under conscious sedation and use of intraoperative MRI can increase the efficiency and safety of glioma resections. In contrast to craniotomies under general anesthesia, neurosurgery under conscious sedation requires several changes to the routine operative setup when performed in the ioMRI environment. This work reports our experience with awake craniotomies under conscious sedation using ioMRI.
Seven patients underwent awake-craniotomies for resection of supratentorial gliomas using ioMRI at the Ohio State University Medical Center and James Cancer Hospital by a single surgeon.
ioMRI can be safely employed in patients who are undergoing craniotomies under conscious sedation. Particularly important is the evaluation by the anesthesiologist whether the patient is a good candidate to sustain a likely longer than average procedure in a setting where his active cooperation is not only required, but also the essential aspect of this procedure.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsAbbreviations
- ioMRI:
-
intraoperative Magnetic Resonance Imaging
References
Black PM, Moriarty T, Alexander ER, Stieg P, Woodard EJ, Gleason PL, Martin CH, Kikinis R, Schwartz RB, Jolesz FA (1997) Development and implementation of intraoperative magnetic resonance imaging and its neurosurgical applications. Neurosurgery 41:831–842, discussion 842–845
Maesawa S, Fujii M, Nakahara N, Watanabe T, Saito K, Kajita Y, Nagatani T, Wakabayashi T, Yoshida J (2009) Clinical indications for high-field 1.5T intraoperative magnetic resonance imaging and neuro-navigation for neurosurgical procedures. Review of initial 100 cases. Neurol Med Chir (Tokyo) 49:340–349, discussion 349–350
Schwartz RB, Hsu L, Wong TZ, Kacher DF, Zamani AA, Black PM, Alexander ER, Stieg PE, Moriarty TM, Martin CA, Kikinis R, Jolesz FA (1999) Intraoperative MR imaging guidance for intracranial neurosurgery: experience with the first 200 cases. Radiology 211:477–488
Albert FK, Forsting M, Sartor K, Adams HP, Kunze S (1994) Early postoperative magnetic resonance imaging after resection ofmalignant glioma: objective evaluation of residual tumor and its influence on regrowth and prognosis. Neurosurgery 34:45–60, discussion 60–61
Hess KR (1999) Extent of resection as a prognostic variable in the treatment of gliomas. J Neurooncol 42:227–231
Lacroix M, Abi-Said D, Fourney DR, Gokaslan ZL, Shi W, DeMonte F, Lang FF, McCutcheon IE, Hassenbusch SJ, Holland E, Hess K, Michael C, Miller D, Sawaya R (2001) A multivariate analysis of 416 patients with glioblastoma multiforme: prognosis, extent of resection, and survival. J Neurosurg 95:190–198
Martin C, Alexander ER, Wong T, Schwartz R, Jolesz F, Black PM (1998) Surgical treatment of low-grade gliomas in the intraoperative magnetic resonance imager. Neurosurg Focus 4:e8
Hall WA, Kowalik K, Liu H, Truwit CL, Kucharezyk J (2003) Costs and benefits of intraoperative MR-guided brain tumor resection. Acta Neurochir Suppl 85:137–142
Hall WA, Liu H, Maxwell RE, Truwit CL (2003) Influence of1.5-Tesla intraoperative MR imaging on surgical decision making. Acta Neurochir Suppl 85:29–37
Hirschl RA, Wilson J, Miller B, Bergese S, Chiocca EA (2009) The predictive value of low-field strength magnetic resonance imaging for intraoperative residual tumor detection. Clinical article. J Neurosurg 111:252–257
Albert FK, Forsting M (2003) Resection and prognosis. J Neurosurg 98:225–226, author reply 226
Berger MS, Deliganis AV, Dobbins J, Keles GE (1994) The effect of extent of resection on recurrence in patients with low grade cerebral hemisphere gliomas. Cancer 74:1784–1791
Senft C, Seifert V, Hermann E, Franz K, Gasser T (2008) Usefulness of intraoperative ultra low-field magnetic resonance imaging in glioma surgery. Neurosurgery 63:257–266, discussion 266–267
Staubert A, Pastyr O, Echner G, Oppelt A, Vetter T, Schlegel W, Bonsanto MM, Tronnier VM, Kunze S, Wirtz CR (2000) An integrated head-holder/coil for intraoperative MRI in open neurosurgery. J Magn Reson Imaging 11:564–567
Wirtz CR, Tronnier VM, Bonsanto MM, Knauth M, Staubert A, Albert FK, Kunze S (1997) Image-guided neurosurgery with intraoperative MRI: update of frameless stereotaxy and radicality control. Stereotact Funct Neurosurg 68:39–43
Nimsky C, Ganslandt O, Tomandl B, Buchfelder M, Fahlbusch R (2002) Low-field magnetic resonance imaging for intraoperative use in neurosurgery: a 5-year experience. Eur Radiol 12:2690–2703
Oh DS, Black PM (2005) A low-field intraoperative MRI system for glioma surgery: is it worthwhile? Neurosurg Clin N Am 16:135–141
Schulder M, Carmel PW (2003) Intraoperative magnetic resonance imaging: impact on brain tumor surgery. Cancer Control 10:115–124
Tan TK, Leong KW (2009) Awake craniotomy in an intra-operative MRI environment. Anaesthesia 64:575–576
Nabavi A, Goebel S, Doerner L, Warneke N, Ulmer S, Mehdorn M (2009) Awake craniotomy and intraoperative magnetic resonance imaging: patient selection, preparation, and technique. Top Magn Reson Imaging 19:191–196
Bergese SD, Puente EG (2009) Anesthesia in the intraoperative MRI environment. Neurosurg Clin N Am 20:155–162
Zorzi F, Saltarini M, Bonasin P (2008) Anesthetic management in awake craniotomy. Signa vitae 3:28–32
Conte V, Baratta P, Tomaselli P, Songa V, Magni L, Stocchetti N (2008) Awake neurosurgery: an update. Minerva Anestesiol 74:289–292
Piccioni F, Fanzio M (2008) Management of anesthesia in awake craniotomy. Minerva Anestesiol 74:393–408
Whittle IR, Borthwick S, Haq N (2003) Brain dysfunction following ‘awake’ craniotomy, brain mapping and resection of glioma. Br J Neurosurg 17:130–137
Duffau H, Lopes M, Denvil D, Capelle L (2001) Delayed onset of the supplementary motor area syndrome after surgical resection of the mesial frontal lobe: a time course study using intraoperative mapping in an awake patient. Stereotact Funct Neurosurg 76:74–82
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2011 Springer-Verlag/Wien
About this chapter
Cite this chapter
Peruzzi, P., Puente, E., Bergese, S., Chiocca, E.A. (2011). Intraoperative MRI (ioMRI) in the Setting of Awake Craniotomies for Supratentorial Glioma Resection. In: Pamir, M., Seifert, V., Kiris, T. (eds) Intraoperative Imaging. Acta Neurochirurgica Supplementum, vol 109. Springer, Vienna. https://doi.org/10.1007/978-3-211-99651-5_7
Download citation
DOI: https://doi.org/10.1007/978-3-211-99651-5_7
Published:
Publisher Name: Springer, Vienna
Print ISBN: 978-3-211-99650-8
Online ISBN: 978-3-211-99651-5
eBook Packages: MedicineMedicine (R0)