Significant improvement in neuropsychological functions after awake craniotomy in a patient with Oligodendroglioma: A case report

TY - JOUR

T1 - Significant improvement in neuropsychological functions after awake craniotomy in a patient with Oligodendroglioma: A case report

AU - Thomas, Mareike

AU - Scheer, Maximilian

AU - Spindler, Kai

AU - Nieberlein, Laura

AU - Hartwigsen, Gesa

AU - Gussew, Alexander

AU - Schob, Stefan

AU - Prell, Julian

AU - Strauss, Christian

AU - Rampp, Stefan

PY - 2023/9

Y1 - 2023/9

N2 - ObjectiveThe goal of awake craniotomy in glioma patients is sparing of cognitive function. Previous investigations suggest that patients in the postoperative state may reach their preoperative level regarding domain-based criteria. Data on significant postoperative improvement beyond the preoperative level is sparse. This article examines the prospective neuropsychological assessment of a glioma patient who underwent awake craniotomy and has shown functional improvement exceeding preoperative levels.MethodsA 34-year-old patient with high premorbid cognitive function level who underwent awake craniotomy for left frontal oligodendroglioma was neuropsychologically assessed and took part in a fMRI-examination at 3 different time points.ResultsPreoperative examination revealed severe isolated impairment of working memory, long-term narrative memory in free recall and recognition, and alertness with intact language production and comprehension. After transient global aphasia in the postoperative state, the follow-up examination showed significant improvement in memory and attention exceeding the preoperative level.ConclusionsTumor location is an important factor in terms of surgical procedures. Cognitive impairment is, however, not always associated with a specific location. Mechanical pressure of the tumor might have led to the isolated consolidation deficit which fully recovered after tumor removal. Psychological disorders should be taken into account regarding prodromal symptoms of neurooncological diseases.

AB - ObjectiveThe goal of awake craniotomy in glioma patients is sparing of cognitive function. Previous investigations suggest that patients in the postoperative state may reach their preoperative level regarding domain-based criteria. Data on significant postoperative improvement beyond the preoperative level is sparse. This article examines the prospective neuropsychological assessment of a glioma patient who underwent awake craniotomy and has shown functional improvement exceeding preoperative levels.MethodsA 34-year-old patient with high premorbid cognitive function level who underwent awake craniotomy for left frontal oligodendroglioma was neuropsychologically assessed and took part in a fMRI-examination at 3 different time points.ResultsPreoperative examination revealed severe isolated impairment of working memory, long-term narrative memory in free recall and recognition, and alertness with intact language production and comprehension. After transient global aphasia in the postoperative state, the follow-up examination showed significant improvement in memory and attention exceeding the preoperative level.ConclusionsTumor location is an important factor in terms of surgical procedures. Cognitive impairment is, however, not always associated with a specific location. Mechanical pressure of the tumor might have led to the isolated consolidation deficit which fully recovered after tumor removal. Psychological disorders should be taken into account regarding prodromal symptoms of neurooncological diseases.

U2 - 10.1016/j.inat.2023.101796

DO - 10.1016/j.inat.2023.101796

M3 - Case report

VL - 33

JO - INTERDISCIP NEUROSUR

JF - INTERDISCIP NEUROSUR

SN - 2214-7519

M1 - 101796

ER -