title: Patients' perspective on awake craniotomy for brain tumors-single center experience in Brazil.
abstract: Awake craniotomy with brain mapping is the gold standard for eloquent tissue localization. Patients' tolerability and satisfaction have been shown to be high; however, it is a matter of debate whether these findings could be generalized, since patients across the globe have their own cultural backgrounds and may perceive and accept this procedure differently.
  
  
  
  We conducted a prospective qualitative study about the perception and tolerability of awake craniotomy in a population of consecutive brain tumor patients in Brazil between January 2013 and April 2015. Seventeen patients were interviewed using a semi-structured model with open-ended questions.
  
  
  
  Patients' thoughts were grouped into five categories: (1) overall perception: no patient considered awake craniotomy a bad experience, and most understood the rationale behind it. They were positively surprised with the surgery; (2) memory: varied from nothing to the entire surgery; (3) negative sensations: in general, it was painless and comfortable. Remarks concerning discomfort on the operating table were made; (4) postoperative recovery: perception of the postoperative period was positive; (5) previous surgical experiences versus awake craniotomy: patients often preferred awake surgery over other surgery under general anesthesia, including craniotomies.
  
  
  
  Awake craniotomy for brain tumors was well tolerated and yielded high levels of satisfaction in a population of patients in Brazil. This technique should not be avoided under the pretext of compromising patients' well-being.
authors.affiliation: Departamento de Neurocirurgia, Hospital Universitario Antonio Pedro, Universidade Federal Fluminense, Rua Marques de Parana, 303, 3o andar, 24033-900, Niteroi, Rio de Janeiro, Brazil. rafael_tmleal@yahoo.com.br.
authors.forename: Rafael Teixeira Magalhaes
authors.initials: RT
authors.lastname: Leal
authors.affiliation: Departamento de Neurocirurgia, Hospital Universitario Antonio Pedro, Universidade Federal Fluminense, Rua Marques de Parana, 303, 3o andar, 24033-900, Niteroi, Rio de Janeiro, Brazil.
authors.forename: Clovis Orlando
authors.initials: CO
authors.lastname: da Fonseca
authors.affiliation: Departamento de Neurocirurgia, Hospital Universitario Antonio Pedro, Universidade Federal Fluminense, Rua Marques de Parana, 303, 3o andar, 24033-900, Niteroi, Rio de Janeiro, Brazil.
authors.forename: Jose Alberto
authors.initials: JA
authors.lastname: Landeiro
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000601:surgery; D001938:Brazil; D003399:Craniotomy / Q000009:adverse effects / Q000379:methods* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D014851:Wakefulness
keywords: Awake craniotomy; Brain mapping; Brain tumor; Qualitative research