AIIMS Performs ‘Awake’ Brain Tumour Surgery On 5-Year-Old Girl, What You Should Know About ‘Awake Craniotomy’

aiims performs ‘awake’ brain tumour surgery on 5-year-old girl, what you should know about ‘awake craniotomy’

A five-year-old girl underwent an awake brain tumour surgery at All India Institute Of Medical Sciences (AIIMS), Delhi on January 4. Doctors at AIIMS performed the brain surgery while keeping her in a conscious state and she was the youngest patient in the world to undergo the surgery.

The surgery is also known as ‘awake brain surgery’ or ‘awake craniotomy’ and was performed on Akshita (the five-year-old girl) for the left perisylvian intraaxial brain tumour.

A statement from AIIMS said that Akshita had a history of seizures and her brain MRI showed a tumour in the left side of her brain adjacent to the speech/language area. The surgery lasted for three hours and the tumour was removed successfully.

“Technological adjuncts viz preoperative functional MRI brain, intraoperative ultrasonography, neuronavigation were used to localise tumour precisely during resection while mapping of functional areas was being carried out under awake conditions. Ice-cold saline was used for the brain surface to prevent any seizures during the procedure,” the statement said.

“The child is doing well and will be sent home on Monday,” it said.

The statement also said, “Awake surgeries for brain tumours are done for maximising tumour removals and minimising neurological deficits usually. During awake craniotomy, patients should feel a minimum level of pain while being completely able to cooperate in neurological tests.”

Read on to know more about Awake Brain Surgery

Mayo Clinic says, “Awake brain surgery is used to treat some brain (neurological) conditions, including some brain tumours or epileptic seizures. If your tumour or the area of your brain where your seizures occur (epileptic focus) is near the parts of your brain that control vision, movement or speech, you may need to be awake during surgery. Your surgeon may ask you questions and monitor the activity in your brain as you respond.

“Your responses help your surgeon to ensure that he or she treats the correct area of your brain needing surgery. The procedure also lowers the risk of damage to functional areas of your brain that could affect your vision, movement or speech.”

If surgical removal of the tumour is required, doctors have to make sure that they do not harm regions of the brain responsible for language, speech, and motor skills. Identifying these areas accurately before surgery poses a challenge. Awake brain surgery enables the surgeon to pinpoint precisely which brain regions govern these functions and avoid any damage.

What are the risks of awake brain surgery?

Patients undergoing this procedure may experience anxiety and discomfort due to the necessity of remaining awake and responsive during certain stages of the surgery. There is also a potential for complications such as infection, bleeding or adverse reactions to anaesthesia. The nature of manipulating the brain while the patient is conscious raises the possibility of unintended neurological issues.

The success of awake brain surgery relies heavily on the patient’s ability to cooperate and communicate with the surgical team throughout the procedure. Despite these risks, the technique continues to be employed when deemed necessary, providing an invaluable means of preserving critical brain functions while addressing medical conditions.

The results of awake brain surgery

Mayo Clinic says, “If you had awake brain surgery to manage epilepsy, you generally should see improvements in your seizures after surgery. Some people are seizure-free, while others experience fewer seizures than before the surgery. Occasionally, some people have no change in the frequency of their seizures.

“If you had awake brain surgery to remove a tumour, your neurosurgeon generally should have been able to remove most of the tumour. You may still need other treatments, such as radiation therapy or chemotherapy, to help destroy remaining parts of the tumour.”