gms | German Medical Science

Objective: Although neuro-oncological surgery focuses on maximizing tumor resection while preserving neurological function, the effect of both, the tumor itself and the surgical procedure on patients´ psychologyand neurocognitionhas hitherto often been neglected.We therefore aimed at investigatingthepre- and postoperative neuropsychological status in a homogeneous cohortof patients undergoing awake surgery.

Methods: Among 54 patients who underwent awake craniotomy from 01/2012 to 07/2016, 30 patients were operated onfor lesions in the left inferior frontal gyrus (n=10), theleft anterior temporal lobe (n=7) or the temporoparietal region (n=13).Preoperative baseline neuropsychological evaluation was performed in all patients, of whom a subset of 14 patients underwent further postoperative neuropsychological follow-up. For testing a neuropsychological battery including tests for language, memory, attention, alertness and depression was used.

Results: Before surgery, nearly all patients presented slight verbal working memory difficulties, and word fluency was reduced in 47% of patients. These functions aswell as short-term memory and attention declined during the first months after surgery, but thereafter fully recovered in all but two patients, still suffering from very slight verbal memory deficits.

Conclusion: Our results underline the relevance of assessing neuropsychological deficits, both, pre- and postoperatively, which might indicate the importance of cognitive rehabilitation after surgery, resulting in full cognitive long-term recovery in most patients.