Surgery-Independent Language Function Decline in Patients Undergoing Awake Craniotomy

Abstract Background Despite selection process before awake-craniotomy, some patients experience an unexpected decline in language functions in the operating-room (OR), compared to their baseline evaluation, which may impair their functional monitoring. To investigate this phenomenon we prospectively compared language function day-before surgery and upon entrance to the OR. Methods Data was prospectively collected from consecutive patients undergoing awake-craniotomy with intra-operative cortical mapping for resection of gliomas affecting language areas. Language functions of 79 patients were evaluated and compared 1-2 days prior to surgery, and after entering the OR. Changes in functional linguistic performance were analyzed with respect to demographic, clinical and pathological characteristics. Results There was a significant decline in language function, beyond sedation effect, after entering the OR, (from median/ interquartile range (IQR):0.94/0.72-0.98 to median/IQR:0.86/0.51-0.94; Z=-7.19, p