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Objectives: Build the theoretical and evidence-base for a digital platform (map-OR) which delivers intraoperative language tests during awake craniotomy and facilitates collaborative sharing of brain mapping data.
Design: Mixed methodology study including two scoping reviews, international survey, synthesis of development guiding principles and a risk assessment using failure modes and effects analysis.
Setting: The two scoping reviews examined the literature published in the English language. International survey was completed by members of awake craniotomy teams from 14 countries.
Main Outcome Measures: Scoping review 1: number of technologies described for language mapping during awake craniotomy. Scoping review 2: barriers and facilitators to adopting novel technology in surgery. International survey: degree of language mapping technology penetration into clinical practice.
Results: A total of 12 research articles describing 6 technologies were included. The technologies required a range of hardware components including portable devices, virtual reality headsets and large integrated multiscreen stacks. The facilitators and barriers of technology adoption in surgery were extracted from 11 studies and mapped onto the 4 Unified Theory of Acceptance and Use of Technology constructs. A total of 37 awake craniotomy teams from 14 countries completed the survey. Of the responses, 20 (54.1%) delivered their language tests digitally, 10 (27.0%) delivered tests using cards and 7 (18.9%) used a combination of both. The most commonly used devices were tablet computers (67.7%; n=21) and the most common software used was Microsoft PowerPoint (60.6%; n=20). Four key risks for the proposed digital platform were identified, the highest risk being a software and internet connectivity failure during surgery.
Conclusions: This work represents a rigorous and structured approach to the development of a digital platform for standardized intraoperative language testing during awake craniotomy and for collaborative sharing of brain mapping data.
Trial Registration Number: Scoping review protocol registrations in OSF registries (scoping review 1: osf.io/su9xm; scoping review 2: osf.io/x4wsc).
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http://dx.doi.org/10.1136/bmjsit-2023-000234 | DOI Listing |
Korean J Anesthesiol
September 2025
Department of Anesthesiology, Nagoya University Hospital, Showa-ku, Nagoya city, Aichi, Japan.
Neurosurg Rev
September 2025
Service de Neurochirurgie, GHU-Paris Psychiatrie et Neurosciences, Site Sainte Anne, Paris, F-75014, France.
Awake craniotomy is the gold standard to achieve maximal safe resection of brain lesions located within eloquent areas. There are no established guidelines to assess patient's eligibility for awake craniotomy by weight class. This study assesses feasibility, safety, and efficacy of awake surgery by weight classes through an observational, retrospective, single-institution cohort analysis (2010-2024) of 526 awake craniotomies.
View Article and Find Full Text PDFNeurochirurgie
September 2025
Neurosurgery Department, Pasteur 2 Hospital, University Hospital of Nice, France; UR2CA PIN, Université Côte d'Azur, France. Electronic address:
Background: Treating symptomatic deep-seated cerebral cavernous malformations (CCMs) is challenging due to surgical risks.
Case Description: A 37-year-old man underwent awake craniotomy with direct electrical stimulation (DES) for excision of a left posterior thalamic CCM. A transcortical transventricular approach through the superior parietal lobe enabled safe navigation around critical associative and projection white matter tracts.
J Clin Neurosci
September 2025
Department of Neurosurgery, National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai 200040, China; Department of Neurosurgery, National Regional Medical Center, Huashan Hospital Fujian Campus, Fudan University, Fuzhou, Fujian 350209, China; Neurosurgical Institute of
The brain arteriovenous malformation (BAVM) within language-eloquent area poses a significant surgical challenge, demanding meticulous planning to ensure both preservation of language function and curative resection. This report details the successful microsurgical resection of a Spetzler-Martin grade II BAVM located in Wernicke's area in a 51-year-old male, ruptured three weeks ago and characterized by mild anomia. Following thorough discussion, the patient elected for microsurgery, providing informed consent, and the procedure was approved by the ethics committee.
View Article and Find Full Text PDFPLoS One
September 2025
LaTIM - Laboratoire de Traitement de l'Information Médicale, UMR INSERM 1101, Hôpital Morvan, Brest, France.
Introduction: The VIRAS (Virtual Reality in Awake Surgery) project is a two-stage, adaptive study. Its goal is to demonstrate the tolerance of the virtual reality (VR) headset for performing cognitive neuro-monitoring during awake brain surgery. Awake surgery involves operating on patients who remain conscious during the procedure and is most commonly employed in interventions such as tumor resections and epilepsy treatments.
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