Awake Craniotomy in 35 Years Old Man with Supratentorial SOL at Left Frontal due

to Suspect Oligodendroglioma DD/ Astrocytoma : a Case Report

Introduction : Awake craniotomy (AC) adalah prosedur operasi yang digunakan

untuk melakukan reseksi tumor intrakranial yang melibatkan eloquent cortex.
Prosedur ini sudah lazim dilakukan dalam ranah bedah saraf, namun di Indonesia
sendiri, belum banyak layanan kesehatan yang dapat melakukan prosedur AC.
Prosedur ini mengharuskan pasien dalam kondisi sadar dan dapat kooperatif pada
saat operasi dilakukan. Proses anestesi pada AC dilakukan dengan menggunakan
anestesi lokal dan sedasi yang termonitor. Pada laporan kasus ini, kami

Awake craniotomy (AC) using local anesthesia and monitored sedation in intracranial
tumor removal involving eloquent cortex has been considered as an acceptable
technique. It allows intraoperative mapping that facilitates radical tumor resection
while minimizing morbidity by preserving functional tissue. Anesthesia for
intracranial procedure requiring patient cooperation present a challenge to the
anesthesiologist. Heretofore, there are not many health services in Indonesia that
can perform awake craniotomy surgery. In this report, we provide

Awake craniotomy is a procedure

Administering anesthesia to conjoined twins outside of the operating room is a

highly complex task that poses a significant challenge to anesthesiologists. The
added complexity of simultaneously managing two patients only serves to further
complicate an already intricate process. In this report, we provide a detailed account
of our efforts to prepare for the administration of anesthesia during magnetic
resonance imaging of conjoined twins.

Case : Ten-months old thoracoomphalopagus conjoined twin girls were admitted

to our Hospital for radiological investigation (MRI). The twins were fused from the
upper chest to the umbilicus, with separate heads and chest (lungs and hearts). Two
separate fully developed spines were noted. In the abdomen, 2 stomachs and a
common shared liver were noted. The twins had separate pelvises, urinary systems
and 2 pairs of limbs each

Discussion : There are 2 method that can be used in managing Children undergoing
radiological investigation which are Sedation (MAC) and General Anesthesia.
Anesthesia in radiology has its unique problems.

Conclusion : General Anesthesia appeared to be more efficient in terms of time to

onset of procedure but resulted in longer duration of recovery in the hospital. We
choose to use Sedation instead of General Anesthesia because of the children
condition that were special and complex so we don’t have to mess with their body
physiology too much and its cost friendly.