Surgeons study 'awake aneurysm surgery' for better outcomes

August 15, 2017, Saint Louis University
Saleem Abdulrauf, M.D., chair of neurosurgery at Saint Louis University and a SLUCare surgeon at SSM Health Saint Louis University Hospital. Credit: Saint Louis University

In a first time study published in the August edition of the Journal of Neurosurgery, Saint Louis University surgeons and researchers report that the use of conscious sedation - also called "awake brain surgery" - allowed them to make adjustments mid-surgery to lower risks during aneurysm surgery.

The research was led by Saleem Abdulrauf, M.D., chair of neurosurgery at Saint Louis University and a SLUCare surgeon at SSM Health Saint Louis University Hospital. Abdulrauf is encouraged by the results of this study, which he hopes can reduce the risks associated with this type of brain .

"Awake surgery for brain aneurysms may open a new frontier in neurosurgery that could lead to improved outcomes and decreased risk," says Abdulrauf. "This initial study is encouraging."

Surgeons use a technique called "clipping" to limit the damage of brain aneurysms, weak areas in that can bulge or rupture. In this procedure, patients typically are given general anesthesia, the skull is opened by surgeons, and the artery is clipped below the aneurysm to prevent it from bursting.

Ischemia - inadequate blood supply to a part of the body - is a significant risk during this procedure that can cause .

Abdulrauf and his team wanted to know if adding "awake" neurological testing to the procedure could help limit this risk. Awake surgery, through , has been used in in order for patients to maintain consciousness and communicate with doctors, giving surgeons "real time" information to see how their patients' brains are functioning during a surgery.

In the current study, 30 patients with aneurysms that had not burst were given awake neurological testing during their procedure. Three patients developed symptoms of during the course of surgery.

Because the use of conscious sedation allowed the surgery team to communicate with these patients and note the nature of the neurological symptoms, the surgeons were able to make adjustments during surgery and eliminate the that were being cause by lack of blood flow.

The researchers concluded that these patients benefited from the awake neurological testing by decreasing their risk of ischemic injury. Though more study is needed, the team is pleased that the study shows an avenue to explore as they aim to reduce risks associated with this type of brain surgery.

Explore further: SLU neurosurgeon pushes brain bypass to new heights

More information: Saleem I. Abdulrauf et al. "Awake" clipping of cerebral aneurysms: report of initial series, Journal of Neurosurgery (2016). DOI: 10.3171/2015.12.JNS152140

Related Stories

SLU neurosurgeon pushes brain bypass to new heights

April 15, 2011
On the cover of a recent edition of the journal Neurosurgery, the highest circulation medical journal in the field, readers saw an artist's intricate depiction of the high-flow brain bypass technique developed by SLU professor ...

Indian man who played guitar during brain surgery makes recovery

July 20, 2017
An Indian man who strummed the guitar as surgeons operated on his brain demonstrated Thursday how the unusual procedure had cured the problem hindering his ability to play.

Subcortical damage is 'primary cause' of neurological deficits after 'awake craniotomy'

February 7, 2013
Injury to the subcortical structures of the inner brain is a major contributor to worsening neurological abnormalities after "awake craniotomy" for brain tumors, reports a study in the February issue of Neurosurgery, official ...

Hypnosis may provide new option for 'awake surgery' for brain cancer

December 28, 2015
Could hypnosis help to reduce the psychological trauma associated with "awake craniotomy" for brain cancers? A new "hypnosedation" technique offers a new alternative for patients undergoing awake surgery for gliomas, suggests ...

Conscious sedation is a safe alternative to general anesthesia for heart valve procedure

April 11, 2017
UCLA scientists have found that conscious sedation—a type of anesthesia in which patients remain awake but are sleepy and pain-free—is a safe and viable option to general anesthesia for people undergoing a minimally invasive ...

Recommended for you

Surprise finding—for very sick elderly, lighter sedation won't drop risk of postoperative delirium, study suggests

August 13, 2018
Johns Hopkins Medicine researchers say a study designed to see if reducing the amount of anesthesia reduces the risk of postoperative delirium in older patients surprisingly found that lighter sedation failed to do so in ...

Kidney transplant chains more effective in saving lives

August 9, 2018
New research from the UBC Sauder School of the Business has found that transplant societies which prioritize kidney transplant chains over kidney exchanges can increase the total number of transplants, thereby saving more ...

Surgical mesh implants may cause autoimmune disorders

July 31, 2018
Surgical mesh implants, often used for hernia or gynecological repair, may be the reason so many patients report symptoms of an autoimmune disorder, according to a University of Alberta rheumatologist.

Surgeons discuss options when the risks of surgery may be too high

July 27, 2018
In an essay published July 26 in the New England Journal of Medicine, Ira Leeds, M.D., research fellow, and David Efron, M.D., professor of surgery, both of the Johns Hopkins University School of Medicine, along with their ...

Blood plasma during emergency air transport saves lives

July 25, 2018
Two units of plasma given in a medical helicopter on the way to the hospital could increase the odds of survival by 10 percent for traumatically injured patients with severe bleeding, according to the results of a national ...

The dark side of antibiotic ciprofloxacin

July 25, 2018
The use of ciprofloxacin and other antibiotics of the class of fluoroquinolones may be associated with disruption of the normal functions of connective tissue, including tendon rupture, tendonitis and retinal detachment. ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.