naa a22 4500 510743935 CHVBK 20180411083038.0 cr unu---uuuuu 180411e20130401xx s 000 0 eng 10.1007/s12630-013-9893-y doi (NATIONALLICENCE)springer-10.1007/s12630-013-9893-y Awake craniotomy in a developmentally delayed blind man with cognitive deficits [Elektronische Daten] [Mark Burbridge, Mateen Raazi] Craniotomie éveillée chez un homme aveugle avec un retard de développement et des troubles cognitifs Purpose: To describe the complex perioperative considerations and anesthetic management of a cognitively delayed blind adult male who underwent awake craniotomy to remove a left anterior temporal lobe epileptic focus. Clinical features: A 28-yr-old left-handed blind cognitively delayed man was scheduled for awake craniotomy to resect a left anterior temporal lobe epileptic focus due to intractable epilepsy despite multiple medications. His medical history was also significant for retinopathy of prematurity that rendered him legally blind in both eyes and an intracerebral hemorrhage shortly after birth that resulted in a chronic brain injury and developmental delay. His cognitive capacity was comparable with that of an eight year old. Since patient cooperation was the primary concern during the awake electrocorticography phase of surgery, careful assessment of the patient's ability to tolerate the procedure was undertaken. There was extensive planning between surgeons and anesthesiologists, and a patient-specific pharmacological strategy was devised to facilitate surgery. The operation proceeded without complication, the patient has remained seizure-free since the procedure, and his quality of life has improved dramatically. Conclusion: This case shows that careful patient assessment, effective interdisciplinary communication, and a carefully tailored anesthetic strategy can facilitate an awake craniotomy in a potentially uncooperative adult patient with diminished mental capacity and sensory deficits. Canadian Anesthesiologists' Society, 2013 Burbridge Mark Department of Anesthesiology, Perioperative Medicine and Pain Management, Royal University Hospital, University of Saskatchewan, G525-103 Hospital Drive, S7N 0W8, Saskatoon, SK, Canada aut Raazi Mateen Department of Anesthesiology, Perioperative Medicine and Pain Management, Royal University Hospital, University of Saskatchewan, G525-103 Hospital Drive, S7N 0W8, Saskatoon, SK, Canada aut Canadian Journal of Anesthesia/Journal canadien d'anesthésie Springer-Verlag 60/4(2013-04-01), 399-403 0832-610X 60:4<399 2013 60 12630 https://doi.org/10.1007/s12630-013-9893-y text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12630-013-9893-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Burbridge Mark Department of Anesthesiology, Perioperative Medicine and Pain Management, Royal University Hospital, University of Saskatchewan, G525-103 Hospital Drive, S7N 0W8, Saskatoon, SK, Canada aut NATIONALLICENCE 700 1- Raazi Mateen Department of Anesthesiology, Perioperative Medicine and Pain Management, Royal University Hospital, University of Saskatchewan, G525-103 Hospital Drive, S7N 0W8, Saskatoon, SK, Canada aut NATIONALLICENCE 773 0- Canadian Journal of Anesthesia/Journal canadien d'anesthésie Springer-Verlag 60/4(2013-04-01), 399-403 0832-610X 60:4<399 2013 60 12630 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer