The First Awake Craniotomy for Seizure Focus Resection in Iran 2016

Document Type : CASE REPORT


1 Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2 Department of Anesthesiology, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran


Patient with refractory seizure may undergo awake craniotomy when the area to be resected is immediately adjacent to eloquent cortex. An awake craniotomy in a 30-year-old man was conducted using a scalp block, dexmedetomidine, and remifentanil infusion without any airway device throughout the procedure. Dexmedetomidine administered at a loading dose of 1 μg/kg and maintenance dose of 0.2–0.7 μg/kg/h. Remifentanil dose was 0.02 μg/kg/min. The patient remained comfortable and hemodynamically stable throughout the procedure. Cortical electrical stimulation revealed motor cortex overlapped with seizure focus. So that surgical procedure was limited to subpial resection of the epileptic focus. Dexmedetomidine with concurrent scalp block appears to be an useful sedation for awake craniotomy when sophisticated neurological test is required.


Sheshadri V, Chandramouli BA. Pediatric awake craniotomy for seizure focus resection with dexmedetomidine sedation – A case report. J Clin Anesth 2016;32:199-202.  Back to cited text no. 1
Erickson KM, Cole DJ. Anesthetic considerations for awake craniotomy for epilepsy. Anesthesiol Clin 2007;25:535-55, ix.  Back to cited text no. 2
Sagher O, Herrey-Jumper SL. Awake craniotomy and intraoperative neurological decline. In: Mashour GA, Farag E, editors. Case Studies in Neuroanesthesia and Neurocritical Care. 1st ed. New York: Cambridge University Press; 2011.  Back to cited text no. 3
Bekker AY, Kaufman B, Samir H, Doyle W. The use of dexmedetomidine infusion for awake craniotomy. Anesth Analg 2001;92:1251-3.  Back to cited text no. 4
Souter MJ, Rozet I, Ojemann JG, Souter KJ, Holmes MD, Lee L, et al. Dexmedetomidine sedation during awake craniotomy for seizure resection: effects on electrocorticography. J Neurosurg Anesthesiol 2007;19:38-44.  Back to cited text no. 5