About this video

• Video Title: Brain tumor and awake brain surgery: Resection of metastatic melanoma
• Channel: MicroNeuroSurgeryOrg
• Speakers: Not explicitly mentioned, but likely a neurosurgeon and medical staff.
• Duration: 18:42

Overview

This video documents a case of awake brain surgery to resect a solitary brain tumor, identified as metastatic melanoma, in a patient with a history of melanoma and other medical conditions. It details the pre-operative assessment, the awake craniotomy procedure including cortical mapping and functional testing, the tumor resection, and post-operative follow-up.

Key takeaways

• Patient Presentation: A 70+ year old gentleman with multiple comorbidities, including metastatic melanoma, presented with a solitary brain tumor that had progressed despite immunotherapy, leading to hemiparesis and expressive dysphasia.
• Surgical Approach: An awake craniotomy was performed due to the tumor's location adjacent to the motor strip and a large draining vein. This approach allowed for real-time neurological monitoring and functional testing during resection.
• Anesthesia and Mapping: The surgical area was infiltrated with local anesthetic to numb the scalp. Cortical stimulation and mapping were used to identify critical brain areas and ensure the safety of the surgical corridor.
• Tumor Resection: The tumor was carefully resected using low-current bipolar cautery and gentle suction, with the large draining vein temporarily occluded and its neurological impact assessed.
• Post-operative Outcome: The surgery resulted in complete tumor resection with no residual tumor identified. The patient recovered well, with resolution of pre-operative neurological deficits, and subsequently underwent further radiotherapy and immunotherapy.