Journal
JOURNAL OF CLINICAL NEUROSCIENCE
Volume 18, Issue 9, Pages 1254-1256Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.jocn.2010.12.046
Keywords
Awake craniotomy; Far lateral approach; Meningioma; Motor-evoked potential
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We report a patient with an infratentorial lesion resected under a far-lateral approach during awake craniotomy to optimize intraoperative monitoring. A 72-year-old man presented with falls, difficulty walking, and lower extremity weakness. MRI revealed a 2.2 by 2.3 by 2.8 cm mass at the right cervicomedullary junction, with mass effect on the adjacent spinal cord. During two attempts during surgical positioning under general anesthesia, motor evoked potentials were lost. Each time the operation was aborted. During the third operation, the patient underwent monitored, light anaesthesia and was awakened periodically to confirm conscious motor function. The operation proceeded without complication, and postoperatively there was no further decrease in motor function. This is, to our knowledge, the first use of an awake operation for an infratentorial meningioma via the far-lateral approach, demonstrating the technique may be used safely and can be useful in optimizing motor function monitoring. (C) 2011 Published by Elsevier Ltd.
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