title: Psychiatric and Psychologic Impact of Surgery While Awake in Children for Resection of Brain Tumors.
abstract: BACKGROUND
  Intraoperative direct stimulation during surgery while awake is considered to be the gold standard for identifying eloquent cortical sites. Only a few studies have referenced the psychologic impact of this event in the pediatric population.
  
  
  OBJECTIVE
  The aim of this clinical study is to present the psychologic aspects of surgery while awake in children. We question the psychiatric contraindications and age limits, as well as the impact on children, with particular attention to the psychologic conditioning and experience of these patients.
  
  
  METHODS
  Seven patients aged 8-16 years old with brain lesions were operated on while awake between 2008 and 2015. Data collected included perception and memories of surgery and diagnosis and also their real-life experience after surgery. Symptoms of posttraumatic stress disorder or acute stress were investigated.
  
  
  RESULTS
  None of the children had initial psychiatric problems. No psychiatric diagnosis was made before surgery. The child psychiatrist did not contraindicate any child for this procedure. Patients experienced little anticipatory anxiety. No child presented symptoms of posttraumatic stress disorder or acute stress.
  
  
  CONCLUSIONS
  The results are encouraging, allowing us to contemplate using brain surgery while awake for children without particular worries about the psychologic aspect.
authors.affiliation: Department of Child and Adolescent Psychiatry, University Hospital of Angers, Angers, France. Electronic address: elise.riquin@chu-angers.fr.
authors.forename: Elise
authors.initials: E
authors.lastname: Riquin
authors.affiliation: Physical and Rehabilitation Medicine, University Hospital of Angers, Angers, France.
authors.forename: Mickael
authors.initials: M
authors.lastname: Dinomais
authors.affiliation: Department of Child and Adolescent Psychiatry, University Hospital of Angers, Angers, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Malka
authors.affiliation: Department of Anesthesiology, University Hospital of Angers, Angers, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Lehousse
authors.affiliation: Department of Child and Adolescent Psychiatry, University Hospital of Angers, Angers, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Duverger
authors.affiliation: Department of Neurosurgery, University Hospital of Angers, Angers, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Menei
authors.affiliation: Department of Neurosurgery, University Hospital of Angers, Angers, France; Anatomy Laboratory, LUNAM, University of Angers, Angers, France.
authors.forename: Matthieu
authors.initials: M
authors.lastname: Delion
mesh_terms: D000293:Adolescent; D001932:Brain Neoplasms / Q000523:psychology / Q000601:surgery*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000209:etiology*; D009483:Neuropsychological Tests; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D011183:Postoperative Complications / Q000209:etiology*; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology*; D014851:Wakefulness
keywords: Consultation liaison psychiatry; Neurosurgery; Posttraumatic stress disorder; Psycho-oncology; Trauma