The following is a summary of “Awake Craniotomy Surgery in Pediatrics: A Systematic Review,” published in the November 2023 issue of Neurology by Fudhaili et al.

Awake craniotomy, an innovative approach to preventing motor deficits during lesion resection situated within or proximal to functional brain areas, has garnered attention for its utility in pediatric neurosurgery. In this systematic review, the researchers undertook a comprehensive analysis of published studies to evaluate the outcomes of pediatric awake craniotomy. Employing multiple search engines, PubMed, Google Scholar, Web of Science, and Wiley, they meticulously screened titles and abstracts using specific search terms: “awake brain surgery” and “children” or “pediatrics,” “awake craniotomy,” “pediatrics awake craniotomy,” “awake brain surgery pediatrics,” and “tumors.” 

From an initial pool of 54 articles, a thorough review of full-text articles and elimination of duplicates led to the inclusion of 16 pertinent articles for analysis. Their findings revealed that the mean age of pediatric subjects undergoing awake craniotomy was 12.23 years, with a relatively equitable distribution between genders- 52.7% male and 47.3% female participants. 

Notably, tumor resection emerged as the primary indication for this surgical intervention. Almost half of the pediatric patients (47.9%) post-surgery exhibited complete recovery, underscoring the procedure’s favorable outcomes. However, a subset of patients encountered complications, with 7.5% reporting speech deficits as a notable adverse outcome. Overall, the study group’s systematic review synthesized evidence supporting the efficacy and safety of awake brain surgery in averting significant postoperative motor and language deficits in pediatric patients, particularly following tumor resection. 

This comprehensive analysis underscores the feasibility and efficacy of awake craniotomy as a valuable procedure in pediatric neurosurgery, showcasing its potential to prevent adverse outcomes and enhance postoperative recovery in this vulnerable patient population.

Source: sciencedirect.com/science/article/abs/pii/S1878875023011385