Introduction

Multiple studies have demonstrated that improved extent of resection is associated with longer overall survival for patients with both high and low grade glioma. Awake craniotomy was developed as a technique for maximizing resection whilst preserving neurological function.

Methods

We performed a comprehensive review of the literature describing the history, indications, techniques and outcomes of awake craniotomy for patients with glioma.

Results

The technique of awake craniotomy evolved to become an essential tool for resection of glioma. Many perceived contraindications can now be managed. We describe in detail our preferred technique, the testing paradigms utilized, and critically review the literature regarding functional and oncological outcome.

Conclusions

Awake craniotomy with mapping has become the gold standard for safely maximizing extent of resection for tumor in or near eloquent brain. Cortical and subcortical mapping methods have been refined and the technique is associated with an extremely low rate of complications.

中文翻译：

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清醒的神经胶质瘤手术：技术发展和细微差别。

介绍

多项研究表明，高和低度神经胶质瘤患者的切除程度提高与总体生存期延长有关。清醒开颅手术被开发为在保持神经功能的同时最大程度地切除手术的技术。

方法

我们对描述神经胶质瘤患者清醒开颅手术的历史，适应症，技术和结果的文献进行了全面回顾。

结果

清醒的开颅手术技术已发展成为切除神经胶质瘤的重要工具。现在可以管理许多可察觉的禁忌症。我们详细描述了我们的首选技术，使用的测试范式，并严格审查了有关功能和肿瘤学结局的文献。

结论

清醒的开颅颅骨切开术已成为安全地扩大雄辩性大脑或其附近肿瘤切除范围的金标准。皮层和皮层下标测方法已得到完善，该技术的并发症发生率极低。