Result of awake surgery for pediatric eloquent brain area tumors: single-center experience
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ORIGINAL ARTICLE
Result of awake surgery for pediatric eloquent brain area tumors: single-center experience Mikle Talabaev 1 & Kevin Venegas 1 & Gleb Zabrodets 2 & Volha Zmachinskaya 2 & Alexander Antonenko 3 & Dmitry Naumenko 3 & Hanna Salauyeva 1 & Natalia Churyla 4 Received: 31 March 2020 / Accepted: 6 May 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose About half of brain tumors are located in supratentorial regions and 20% of them in eloquent brain cortex areas. The use of fMRI and intraoperative neuromonitoring allows safe surgery of these areas. Carrying out awake brain surgery (ABS) operations provides additional opportunities for direct-function monitoring. In pediatric practice, this method has not been used widely yet. Methods We present the retrospective analysis of the results of pre-operative examination and surgical treatment of 12 patients with glial tumors located in eloquent cortex areas. Two patients had ABS operations twice. Intraoperative neuromonitoring was used in all the cases. Results Twelve patients in total underwent fourteen ABS operations. According to histology results, patients with low-grade tumors prevailed, 11 (91.7%) out of 12. Seven (58.3%) patients had the tumor located in the projection of speech cortex area, four (33.3%) patients in the motor cortex area, and one (8.4%) patient in the visual cortex area. The youngest male was 8 years old. Temporary neurological deficit was diagnosed in three (25%) cases. The tumor was removed completely in 66.7% (eight) cases. Three patients were operated upon twice, two of whom had ABS operations twice. The awake phase of the surgery lasted from 30 to 110 min, 61.2 min on average. Conclusions Our experience has shown sufficient safety of pediatric ABS operations. The achieved functional result and radicality of tumor removal prove that further application and development of this method for children with eloquent brain area tumors (EBATs) is reasonable. Keywords Pediatric awake surgery . Eloquent cortex areas . Pediatric brain tumor . Brain mapping
Introduction Modern neurosurgery considers neurosurgical intervention successful only if complete removal of the pathological
* Mikle Talabaev [email protected] 1
Pediatric Neurosurgery Department, Republican Research and Clinical Center of Neurology and Neurosurgery, Minsk, Belarus
2
Intraoperative Neurophysiological Monitoring Service, Republican Research and Clinical Center of Neurology and Neurosurgery, Minsk, Belarus
3
Department of Neuroradiology, Republican Research and Clinical Center of Neurology and Neurosurgery, Minsk, Belarus
4
Psychological Service, Republican Research and Clinical Center of Neurology and Neurosurgery, Minsk, Belarus
process is achieved with a minimum risk of developing persistent neurological deficit. About 40% of childhood brain tumors are located in supratentorial regions and about 20% in eloquent areas of cerebral cortex in children [6]. In order to preserve the quality of life, the method of awake brain surgery (ABS)
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