Awake Craniotomy Surgery in Pediatrics: A Systematic Review

BACKGROUND: Awake craniotomy is a unique method to prevent motor deficits during the resection of lesions located in or close to functional areas. We sought to study the outcomes of pediatric craniotomy on published studies. METHODS: The search for articles was performed through multiple search engines: PubMed, Google Scholar, Web of Science, and Wiley. The following search terms were used for screening the titles and abstracts: "awake brain surgery" and "children" or "pediatrics," "awake craniotomy," and "children" or "pediatrics," "pediatrics awake craniotomy," "awake brain surgery pediatrics," and "tumors." On initial screening of the titles and abstracts, 54 articles were found. After a thorough review of the full texts of obtained articles and removing duplicates, 16 articles remained. RESULTS: The mean age group was 12.23 years. There was a slight difference between genders who underwent awake craniotomy in the pediatric age group, 52.7% male and 47.3% for female. Tumor resection was the most common indication of the surgery. Almost half (47.9%) experienced complete recovery following the surgery. However, of those who had complicated recovery, 7.5% experienced a speech deficit. CONCLUSIONS: This systematic review summarized that awake brain surgery can prevent significant motor and language deficits postoperatively in children after tumor resection as it is considered a feasible and safe procedure.