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Case Report

Awake Craniotomy for Clipping of Unruptured Aneurysm: Anaesthesia Concerns, Management and Challenges

Wan Mohd Nazaruddin Wan Hassan, Sanihah Che Omar, Teck Fui Wong, Zamzuri Idris, Regunath Kandasamy.


Awake craniotomy is a neurosurgical technique performed either as an asleep-awake-asleep technique or a monitored anaesthesia care technique, in combination with a scalp block. The surgery indication has been well documented for brain tumour excision at the eloquent cortex, epilepsy and deep brain stimulation surgery. However, this technique’s use during unruptured cerebral aneurysm clipping has only been recently reported. The main goal of awake craniotomy for unruptured cerebral aneurysm clipping is to prevent the risk of ischaemia during temporary and permanent clipping by immediate awake neurological assessment during surgery. There are limited reports on this surgery’s anaesthesia issues. The aim of our case report is to discuss the anaesthesia concerns, management and challenges during our first successful experience of this surgery.

Key words: Awake craniotomy, Clipping, Cerebral aneurysm, Scalp block

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