Back to Search
Start Over
Surgery-Independent Language Function Decline in Patients Undergoing Awake Craniotomy
- Source :
- World neurosurgery. 99
- Publication Year :
- 2016
-
Abstract
- Despite selection process before awake-craniotomy, some patients experience an unexpected decline in language functions in the operating room (OR), compared with their baseline evaluation, which may impair their functional monitoring. To investigate this phenomenon we prospectively compared language function the day before surgery and on entrance to the OR.Data were collected prospectively from consecutive patients undergoing awake-craniotomy with intraoperative cortical mapping for resection of gliomas affecting language areas. Language functions of 79 patients were evaluated and compared 1-2 days before surgery and after entering the OR. Changes in functional linguistic performance were analyzed with respect to demographic, clinical, and pathologic characteristics.There was a significant decline in language function, beyond sedation effect, after entering the OR, (from median/interquartile range: 0.94/0.72-0.98 to median/interquartile range: 0.86/0.51-0.94; Z = -7.19, P0.001). Univariate analyses revealed that this decline was related to age, preoperative Karnofsky Performance Scale, tumor location, tumor pathology, and preexisting language deficits. Multivariate stepwise regression identified tumor pathology and the presence of preoperative language deficit as significant independent predictors for this functional decline.Patients undergoing awake-craniotomy may experience a substantial decline in language functioning after entering the OR. Tumor grade and the presence of preoperative language deficits were significant risk factors for this phenomenon, suggesting a possible relation between cognitive reserve, psychobehavioral coping abilities and histologic features of a tumor involving language areas. Capturing and identifying this unique population of patients who are prone to experience such language decline may improve our ability in the future to select patients eligible for awake-craniotomy.
- Subjects :
- Adult
Male
Coping (psychology)
medicine.medical_specialty
Adolescent
Intraoperative Neurophysiological Monitoring
Sedation
Population
03 medical and health sciences
Young Adult
0302 clinical medicine
Cognitive Reserve
Interquartile range
Adaptation, Psychological
medicine
Humans
Prospective Studies
Karnofsky Performance Status
education
Cognitive reserve
Aged
Language
Aged, 80 and over
education.field_of_study
Brain Mapping
business.industry
Brain Neoplasms
Beck Depression Inventory
Age Factors
Glioma
Middle Aged
Surgery
Linguistic performance
030220 oncology & carcinogenesis
Female
Neurology (clinical)
medicine.symptom
Neoplasm Grading
business
030217 neurology & neurosurgery
State-Trait Anxiety Inventory
Craniotomy
Subjects
Details
- ISSN :
- 18788769
- Volume :
- 99
- Database :
- OpenAIRE
- Journal :
- World neurosurgery
- Accession number :
- edsair.doi.dedup.....e2fdda459801e75cff3c911808486be5