Awake brain surgery

Tuesday,  28  Июнь  2022

A native of the Akmola region has recently suddenly begun to be disturbed by complaints of dizziness, speech impairment, absent-mindedness, disorientation in space and time. Doctors at the place of residence sent the woman for diagnosis. On MRI of the brain, the patient was found to have a volumetric formation of the left hemisphere of the brain, with a shift of the median structures to the right, with compression of the lateral ventricle on the left. The left hemisphere of the brain in humans is responsible for such functions as: logic and recognition of images and colors, speech and memory.

Taking into account the difficult diagnosis of the patient, as well as the need to receive highly specialized care, the doctors referred the woman to the National Center for Neurosurgery for surgical treatment.

Doctors of the Department of Brain Neurosurgery of the National Center for Neurosurgery, headed by Professor Nurzhan Ryskeldiev, held a consultation, which determined the tactics of treating the patient.

“The formation was closely located between speech center and went as deep as 5 centimeters. In this clinical case, the patient needed a consciousness-preserving operation, otherwise called an awake operation. Since the tumor was located in functionally significant areas, it was very important not to damage these areas, as well as the vessels. The main task was to remove the formation and preserve all the functions for which the adjacent structures of the brain are responsible. The patient was under intravenous and local anesthesia, pain was not felt. During the removal of the mass, a multidisciplinary team of doctors talked to the patient, asked questions and asked to follow certain commands. All these manipulations significantly determine the further quality of life of the patient and allow avoiding neurological deficit.” - concluded the neurosurgeon Moldabekov Aidos.

Doctors of the Department of Brain Neurosurgery performed a microsurgical removal of the formation on the left using a neuronavigation system and with fluorescence.

The neuronavigation system made it possible to determine the boundaries of the formation and the point of trepanation. Neurophysiological control and direct contact between the speech therapist and the patient were used as a prevention of violations in functionally important areas.

         The operation was successful and was performed for the patient free of charge within the framework of the OSMI for citizens of Kazakhstan. The patient feels well and is preparing for discharge. It should be noted that after the operation, the patient has a positive trend in improving her health. Improvements affected her speech, she does not confuse letters and numbers, she types texts and writes independently, which the patient had difficulty coping with before the operation.

       The operation was performed by a multidisciplinary team of highly specialized doctors of NCN, namely: neurosurgeon of the highest category Aidos Moldabekov, anesthesiologist Raushan Tokshekenova, speech therapist Aigul Sadyrbekova, and neurophysiologist Saule Uteuova.

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