Patient Review
- Patient’s Name: Mr. Ramda Chopade
- Patient’s Age: 58
- Patient’s Gender: male
Symptoms
- Focal seizures and word finding difficulty.
Case Presentation
The current case study describes a patient with a large left frontal tumor in the speech area. Awake craniotomy is the appropriate technique for operating on such cases. When a brain tumor is near critical speech areas of the brain, it may be important to determine the exact location of these speech-related areas. Awake speech mapping may be carried out by applying mild electrical current to the surface of the exposed brain while the patient performs various tasks, such as reading, speaking etc. If the stimulation hinders the task, then that area of the brain is marked and preserved. Typically, the patients feel minimal or no discomfort while being awake during the surgery.
Mr. Ramda Chopade visited the OPD with focal seizures and word-finding difficulty. Brain MRI showed a large left frontal tumor in the speech area. Functional MRI was done which specifically defined the speech area and found that this area is involved with the tumor. Now the difficulty was to remove the tumor without affecting his speech. So I decided to remove his tumor while he is speaking to me. This advanced technique is called Awake craniotomy done at very few centers in the world. We took him to the operation and explained the procedure. While operating we urged him to speak partial phrases and number counting and also showed him pictures so that he can name it. On stimulating partial areas in the brain he stopped answering our questions and we identified the actual speech area. I removed his complete tumor saving his speech. It was one-of-a-kind surgery.
Treatment and prognosis
- Craniotomy is the only way to reliably preserve speech function during tumor resections, benefitting the patients undergoing such a procedure
Physical Examination & Tests
- Brain MRI
- Functional MRI