Predicting sleepiness during an awake craniotomy

• To safely undergo an awake craniotomy, a patient must cooperate the surgery.
• Sleepiness is one of the causes of failure of an awake craniotomy.
• We assess the preoperative cognitive factors related to sleepiness.
• Perioperative sleepiness was correlated with the preoperative cognitive abilities.

ObjectiveAn awake craniotomy is a safe neurological surgical technique that minimizes the risk of brain damage. During the course of this surgery, the patient is asked to perform motor or cognitive tasks, but some patients exhibit severe sleepiness. Thus, the present study investigated the predictive value of a patient's preoperative neuropsychological background in terms of sleepiness during an awake craniotomy.MethodsThirty-seven patients with brain tumor who underwent awake craniotomy were included in this study. Prior to craniotomy, the patient evaluated cognitive status, and during the surgery, each patient's performance and attitude toward cognitive tasks were recorded by neuropsychologists.ResultsThe present findings showed that the construction and calculation abilities of the patients were moderately correlated with their sleepiness.ConclusionThese results indicate that the preoperative cognitive functioning of patients was related to their sleepiness during the awake craniotomy procedure and that the patients who exhibited sleepiness during an awake craniotomy had previously experienced reduced functioning in the parietal lobe.