Abstract
AIMS
Awake craniotomy for brain tumour resection aims to increase the extent of resection while minimising neurological deficit. The major concerns for patients during awake craniotomies include peri-operative discomfort/pain and anxiety for some patients. Older patients are generally not offered aggressive operative options due to longer lengths of hospital stay (LOS), expected higher rates of peri-operative morbidity/mortality, and poorer survival. However, increased extent of glioma resection is associated with greater overall and progression-free survival. Furthermore, previous studies have shown that awake craniotomies are well tolerated in elderly patients. This study aims to evaluate our experience in awake craniotomies for glioma resection in patients over 65 years old.
METHOD
Seventeen elderly patients who had undergone awake craniotomies at University Hospitals of North Midlands between 2015 and 2021 were included. Outcome measures included LOS, post-operative morbidity/mortality, and the difference between pre- and post-operative Hospital Anxiety and Depression scores (HADS).
RESULTS
There was an 11% operative mortality rate in our cohort. The average LOS was 5.7 days. The median pre- and post-operative score at 6 months was 1 indicating that there is no difference post-operatively. There was a positive net difference between pre- and post-operative anxiety/depression scores in our cohort.
CONCLUSION
Awake craniotomies are generally well tolerated among the elderly patients with unchanged post-operative performance status and improved HADS scores. These findings suggest that awake craniotomies should be offered to elderly patients if deemed appropriate.