title: Surgical and anesthesiological considerations of awake craniotomy: Cerrahpasa experience.
abstract: OBJECTIVE
  Awake craniotomy (AC) with electrical cortical stimulation has become popular during the last ten years although the basic principles were introduced almost 50 years ago. The aim of this paper is to share with the readers our experience in 25 patients who underwent AC with electrical stimulation.
  
  
  METHODS
  Twenty-five patients who underwent AC between 2010 and 2013 are the subjects of this paper. All patients were diagnosed with intraaxial lesions involving the functional area itself or very close to it by preoperative imaging. During surgery, the functional area was demonstrated by cortical electrical stimulation and resection aimed to preserve it in order to avoid an irreversible functional deficit.
  
  
  RESULTS
  Total resection was possible in 80% while in 20% subtotal resection had to be performed because of involvement of the functional area itself. The neurological complication rate was found to be 16% (4 patients) and all were transient. No complication regarding anesthesia was noted.
  
  
  CONCLUSIONS
  Awake craniotomy in selected patients is very effective, safe and practical for supratentorial lesions close to the eloquent area. Complications related to the surgery itself are uncommon and general anesthesia is avoided. The hospital stay including the intensive care unit is short which makes it very economical surgical procedure.
authors.affiliation: Istanbul University, Cerrahpasa Medical Faculty, Department of Neurosurgery, Istanbul, Turkey.
authors.forename: Galip Zihni
authors.initials: GZ
authors.lastname: Sanus
authors.forename: Odhan
authors.initials: O
authors.lastname: Yuksel
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Tunali
authors.forename: Cigdem
authors.initials: C
authors.lastname: Ozkara
authors.forename: Naz
authors.initials: N
authors.lastname: Yeni
authors.forename: Fatma
authors.initials: F
authors.lastname: Ozlen
authors.forename: Taner
authors.initials: T
authors.lastname: Tanriverdi
authors.forename: Emin
authors.initials: E
authors.lastname: Ozyurt
authors.forename: Mustafa
authors.initials: M
authors.lastname: Uzan
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000601:surgery*; D002540:Cerebral Cortex / Q000502:physiology / Q000503:physiopathology / Q000601:surgery; D003399:Craniotomy / Q000009:adverse effects / Q000379:methods*; D004558:Electric Stimulation / Q000379:methods; D004827:Epilepsy / Q000601:surgery*; D005260:Female; D006801:Humans; D064795:Intraoperative Neurophysiological Monitoring / Q000379:methods*; D008297:Male; D054220:Malformations of Cortical Development / Q000601:surgery*; D008875:Middle Aged; D016896:Treatment Outcome; D014851:Wakefulness / Q000502:physiology*