In Krasnoyarsk, they successfully carried out a second operation on the brain “with awakening”

In Krasnoyarsk, neurosurgeons and anesthesiologists of the regional clinical hospital successfully performed the second surgical intervention on the brain by AWAKE surgery.

The second patient, who had such an operation, was 57 years old, she suffered from epilepsy. She has already been discharged from the hospital in satisfactory condition. The neurosurgeon of the regional clinical hospital, Professor Pavel Schnyakin, noted that the second operation was more complicated for the surgical brigade.

“Due to some features (excess body weight), this patient was special for AWAKE surgery, as it is proven that such patients may have difficulty breathing during extubation. Indeed, some difficulties arose for the operations, but the team of the anesthetic brigade successfully coped with them, ”the neurosurgeon explained.

The press service of the hospital recalled that the operation begins under anesthesia, but after the skull trepanation, the anesthetist awakens the patient and removes the pipe through which the patient's breathing was ensured. After this, the open brain manipulations are carried out while the patient is conscious.

“The neurosurgeon produces manipulations on the patient’s open brain, and the neurophysiologist at the same time asks him questions, carefully listening to the answers. If the patient is delayed with the answer, the neurosurgeon stops the manipulation and “leaves” from the dangerous zone of the brain. This is done in order not to damage the center of speech during the operation, ”the press service explained.

Before the operation, the patient undergoes a number of specific examinations: long-term video-electroencephalographic monitoring, exposure that provoke an epileptic attack: hyperventilation, photostimulation against the background of anticonvulsant cancellation, sleep deprivation (lack or complete lack of sleep), a study of the patient’s electroencephalogram at a state of physiological sleep. A comprehensive examination helps doctors establish the localization of the area of ​​the brain that provokes attacks. A neuropsychologist also works with patients to assess the risks of memory deterioration and cognitive status in the case of an operation.

Then a consultation, consisting of a neurosurgeon, a neurologist, a neurophysiologist, assesses the ratio of risks and a successful forecast of the outcome of the operation and makes a final decision on surgical intervention.

Note that these are the first such operations in the Krasnoyarsk Territory, earlier AWAKE surgery was performed exclusively in federal medical centers.