“Imagine your neighbor mows the lawn”: a pilot study of psychological sequelae due to awake craniotomy

Monika Milian · Ralf Luerding · Annette Ploppa · Karlheinz Decker · Tsambika Psaras · Marcos Soares Tatagiba +2 more

58 citations0/0 files storedJournal of neurosurgery

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Posttraumatic Stress Disorder Research Traumatic Brain Injury Research Neurosurgical Procedures and Complications

Abstract

OBJECT: Although it has been reported that awake neurosurgical procedures are well tolerated, the long-term occurrence of general psychological sequelae has not yet been investigated. This study assessed the frequency and effects of psychological symptoms after an awake craniotomy on health-related quality of life (HRQOL). METHODS: Sixteen patients undergoing an awake surgery were surveyed with a self-developed questionnaire, the Posttraumatic Stress Disorder Inventory For Awake Surgery Patients, which adopts the core components of the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) posttraumatic stress disorder (PTSD) criteria. The mean time between surgery and data collection was 97.3 ± 93.2 weeks. Health-related quality of life was assessed with the 36-Item Short Form Health Survey. RESULTS: Forty-four percent of the patients stated that they had experienced either repetitive distressing recollections or dreams related to the awake surgery, 18.8% stated persistent avoidance of stimuli associated with the awake surgery, and symptoms of increased arousal occurred in 62.5%. Two patients presented with postoperative psychological sequelae resembling PTSD symptoms. Younger age at surgery and female sex were risk factors for symptoms of increased arousal. The experience of intense anxiety during awake surgery appears to favor the development of postsurgical PTSD symptoms, while recurrent distressing recollections particularly affect HRQOL negatively. CONCLUSIONS: In many cases awake craniotomy is necessary to preserve language and motor function. However, in some cases awake craniotomy can lead to postoperative psychological sequelae resembling PTSD symptoms. Therefore, possible long-term effects of an awake surgery should be considered and discussed with the patient when planning this type of surgery.

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1992The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection.1992The MOS 36-ltem Short-Form Health Survey (SF-36)1995Posttraumatic Stress Disorder in the National Comorbidity Survey 2009Diagnostic and Statistical Manual of Mental Disorders 2001Awareness under anesthesia and the development of posttraumatic stress disorder☆2002Screening for trauma histories, posttraumatic stress disorders (PTSD) and subthreshold PTSD in psychiatric outpatients.2000Predictors of psychological distress following serious injury

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