Surgery of lesions in eloquent areas by functional mapping under awaking anaesthesia:clinical report of five cases

Objective To study the method of functional mapping for eloquent areas under awaking anaesthesia for surgery of lesions in the cerebral eloquent areas. Methods 5 patients with lesions in the eloquent areas were undergone awaking surgery assisted with neuron-navigation system and functional mapping under awaking anaesthesia. Results 5 patients successfully underwent craniotomy under anaethesia with larynx mask and intravenous propofol, the identify of the functional areas and surgical resection of lesions under awaking, and close the cranium under re-anaesthesia during the operation, including 3 cases with pulling out larynx mask, then inserting it during awaking surgery. There is no deterioration of neurofunction after operation. The preoperative dysfunction were improved in all patients, and totally disappeared in three patients. Only one patient who suffered the frequently seizure underwent epileptic attack and no other complications occurred in awake operations. All patients have no painful experience in the operations. Conclusion Functional mapping for eloquent areas by somatosensory evoked potential and direct electrical stimulation under awaking anaesthesia is a reliable, precise and safe method, which allows a maximum resection of the lesions and protection of the normal function.