INS NYC 2024 Program

Poster	Poster Session 09 Program Schedule 02/16/2024 03:30 pm - 04:45 pm Room: Majestic Complex (Posters 61-120) Poster Session 09: Epilepsy \| Oncology \| MS \| Infectious Disease Final Abstract #93 Mapping Neurocognitive Functions in Awake Craniotomy for a Glioma Patient: A Case Report Ann Paul, National Institute of Mental Health & Neuroscience (NIMHANS), Bengaluru, India Dr Jamuna Rajeswaran, National Institute of Mental Health & Neuroscience (NIMHANS), Bengaluru, India Dr Shantala Hegde, National Institute of Mental Health & Neuroscience (NIMHANS), Bengaluru, India Dr Arivazhagan A, National Institute of Mental Health & Neuroscience (NIMHANS), Bengaluru, India Dr Nishanth Sadashiva, National Institute of Mental Health & Neuroscience, Bengaluru, India Dr Mariamma Philip, National Institute of Mental Health & Neuroscience (NIMHANS), Bengaluru, India Dr Gopal K N, National Institute of Mental Health & Neuroscience (NIMHANS), Bengaluru, India Category: Assessment/Psychometrics/Methods (Adult) Keyword 1: brain tumor Keyword 2: neuropsychological assessment Objective: To evaluate the preoperative, intraoperative and postoperative changes in the neuropsychological profile of a patient with left insular glioma undergoing awake craniotomy and how preoperative evaluation guides assessment during the intraoperative period. Participants and Methods: A 29-year-old married female, right-handed, hailing from a rural part of South India, formally educated up to 12^th grade, presented with headache and one episode of generalized tonic-clonic seizures for five months. MRI findings revealed low-grade glioma in the left insula-frontotemporal region. Patient underwent left frontotemporal awake craniotomy and decompression of the lesion with subcortical mapping and awake mapping. A detailed neuropsychological assessment using NIMHANS Neuropsychological Battery (Rao et al., 2004) was administered at two time points: preoperative and at one-month follow-up. A brief intraoperative protocol was customised for the patient and was administered one day prior to surgery, during the surgery and immediately postoperative. The tasks were in the domains of language comprehension, repetition, object and picture naming, verbal fluency, temporal encoding and verbal working memory. Results: The patient endured the surgery well with gross total resection of the lesion. Preoperative impairments were seen in the domains of focused and sustained attention, cognitive flexibility and attentional switching, phonemic and semantic fluency, verbal working memory, response inhibition and set-shifting and concept formation. Tasks based on the findings from preoperative examination and site of impairment were tailored to be used intraoperatively. The immediate postoperative assessment showed language preservation in the patient but further decline in phonemic fluency, verbal working memory and encoding and retrieval of information. One-month follow-up showed improvement in all domains. Conclusions: With its intraoperative mapping, awake craniotomy is the gold-standard treatment in glioma, allowing for maximal resection of tumors while preserving language and motor functions. Carrying out a comprehensive preoperative, intraoperative and postoperative neuropsychological assessment is imperative in assisting the neurosurgical team with the successful excision of tumor and tailoring further intervention post-surgery. Neuropsychologist plays a crucial role in all stages leading to-, during- and after surgery for an overall positive psychological outcome of the individual.

Poster

02/16/2024
03:30 pm - 04:45 pm
Room: Majestic Complex (Posters 61-120)

Poster Session 09: Epilepsy | Oncology | MS | Infectious Disease

Final Abstract #93

Mapping Neurocognitive Functions in Awake Craniotomy for a Glioma Patient: A Case Report

Ann Paul, National Institute of Mental Health & Neuroscience (NIMHANS), Bengaluru, India
Dr Jamuna Rajeswaran, National Institute of Mental Health & Neuroscience (NIMHANS), Bengaluru, India
Dr Shantala Hegde, National Institute of Mental Health & Neuroscience (NIMHANS), Bengaluru, India
Dr Arivazhagan A, National Institute of Mental Health & Neuroscience (NIMHANS), Bengaluru, India
Dr Nishanth Sadashiva, National Institute of Mental Health & Neuroscience, Bengaluru, India
Dr Mariamma Philip, National Institute of Mental Health & Neuroscience (NIMHANS), Bengaluru, India
Dr Gopal K N, National Institute of Mental Health & Neuroscience (NIMHANS), Bengaluru, India

Category: Assessment/Psychometrics/Methods (Adult)

Keyword 1: brain tumor
Keyword 2: neuropsychological assessment

Objective:

To evaluate the preoperative, intraoperative and postoperative changes in the neuropsychological profile of a patient with left insular glioma undergoing awake craniotomy and how preoperative evaluation guides assessment during the intraoperative period.

Participants and Methods:

A 29-year-old married female, right-handed, hailing from a rural part of South India, formally educated up to 12^th grade, presented with headache and one episode of generalized tonic-clonic seizures for five months. MRI findings revealed low-grade glioma in the left insula-frontotemporal region. Patient underwent left frontotemporal awake craniotomy and decompression of the lesion with subcortical mapping and awake mapping. A detailed neuropsychological assessment using NIMHANS Neuropsychological Battery (Rao et al., 2004) was administered at two time points: preoperative and at one-month follow-up. A brief intraoperative protocol was customised for the patient and was administered one day prior to surgery, during the surgery and immediately postoperative. The tasks were in the domains of language comprehension, repetition, object and picture naming, verbal fluency, temporal encoding and verbal working memory.

Results:

The patient endured the surgery well with gross total resection of the lesion. Preoperative impairments were seen in the domains of focused and sustained attention, cognitive flexibility and attentional switching, phonemic and semantic fluency, verbal working memory, response inhibition and set-shifting and concept formation. Tasks based on the findings from preoperative examination and site of impairment were tailored to be used intraoperatively. The immediate postoperative assessment showed language preservation in the patient but further decline in phonemic fluency, verbal working memory and encoding and retrieval of information. One-month follow-up showed improvement in all domains.

Conclusions:

With its intraoperative mapping, awake craniotomy is the gold-standard treatment in glioma, allowing for maximal resection of tumors while preserving language and motor functions. Carrying out a comprehensive preoperative, intraoperative and postoperative neuropsychological assessment is imperative in assisting the neurosurgical team with the successful excision of tumor and tailoring further intervention post-surgery. Neuropsychologist plays a crucial role in all stages leading to-, during- and after surgery for an overall positive psychological outcome of the individual.