Awake Surgery for a Patient With Glioblastoma and Severe Aphasia: Case Report.

Neurosurgery open Pub Date : 2023-02-09 eCollection Date: 2023-03-01 DOI:10.1227/neuprac.0000000000000029
Daisuke Kawauchi, Aiko Matsuoka, Makoto Ohno, Yasuji Miyakita, Masamichi Takahashi, Shunsuke Yanagisawa, Yukie Tamura, Miyu Kikuchi, Takahiro Naka, Tetsufumi Sato, Yoshitaka Narita
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Abstract

Background and importance: Patients with severe aphasia rarely become candidates for awake surgery because the intraoperative tasks of awake surgery for patients with aphasia have not been established.

Clinical presentation: A 50-year-old, right-handed woman presented with recurrent glioblastoma invading her left superior temporal gyrus and inferior parietal lobule. She had severe aphasia, as she could barely verbalize her own name. However, we noticed that she could sing nursery rhymes with simple melodies and applied her singing ability as an axis of awake surgery. During awake surgery, she continuously sang simple songs to detect language dysfunction. As a result, 90% of the tumor was resected, preserving her language function and allowing for improvement. She was discharged 9 days after surgery without further neurological deterioration.

Conclusion: Awake surgery is usually not indicated in patients with severe aphasia. However, for patients with aphasia who retain the ability to sing, intraoperative singing could be a possible alternative to maximize tumor resection while minimizing neurological dysfunction.

脑胶质母细胞瘤合并严重失语症患者的苏醒手术1例报告
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