Subjective experience, cognitive functioning and trauma level of patients undergoing awake craniotomy due to brain tumor - Preliminary study.

BACKUP AND OBJECTIVE: Awake craniotomy (AC) for brain tumors, when the patient is conscious during the operation, allows to reduce the risk of motor disability and aphasia, however, it may be a source of extreme stress. The aim of our study was to examine the patients' subjective experience of the surgery including the level of psychological trauma and cognitive functioning. METHOD: Eighteen patients operated due to brain tumor were enrolled in this study. The Essener Trauma-Inventory Questionnaire and the Addenbrooke's Cognitive Examination (ACE III) were administrated. The patients' experience with awake craniotomy was evaluated with a qualitative descriptive survey. RESULTS: All patients remembered the intraoperative neuropsychological examination and several sensations like: drilling, cold, head clamp fixation or having eyes covered. In most of the patients the postoperative psychological trauma experience did not reach the clinical level. The ACE III postoperative scores revealed partial cognitive deficits with the lowest scores in memory and word fluency domains. Slight amnestic aphasia was observed postoperatively only in two patients. CONCLUSIONS: Awake craniotomy for resection of brain tumors is well-tolerated by patients and does not cause significant psychological trauma. Nonetheless, anxiety about the procedure warrants further study and individualized neuropsychological care is needed for the emotional preparation of the patient.

"Cerebellar lesions after low-grade tumor resection can induce memory impairment in children, similar to that observed in patients with frontal lesions".

The aim of the present study was to specify if cerebellar lesions cause memory impairment in children. The study sample consisted of 44 children with low-grade cerebellar astrocytoma, who underwent surgical treatment and 30 healthy controls, matched with regard to age and sex. Memory was tested using the Rey Auditory Verbal Learning Test AVLT, Corsi Block-Tapping Test, Digit Span, Digit Backwards and Information Subtests from the Wechsler Intelligence Scale for Children-Revised WISC-R (PL). Patients with cerebellar lesions demonstrated memory impairments, similar to those typical for patients with frontal lesions, with auditory and visuospatial working memory deficits, a disorganized learning process without mnemonic strategy (executive dysfunctions) and problems with recalling new material from long-term memory storage, while maintaining good recognition of previously learned material, preserved semantic knowledge and short-term auditory-verbal memory (digit span). Obtained results showed that memory deficits would vary according to the side of the cerebellar lesion, with more pronounced impairment of visuospatial memory tasks accompanying the left-sided cerebellar lesions and worse performance of verbal memory task, observed in the group of patients with right-sided cerebellar lesions. Although the presence of hydrocephalus significantly worsens the memory performance of the children studied, patients with cerebellar lesions without hydrocephalus still present significantly lower memory indicators in the profile described, compared to the control group of healthy children. It confirms the hypothesis that cerebellar lesion alone could result in memory dysfunctions in children.

[The Post Stroke Depression Scale (PSDRS) as a tool for evaluation of depressed mood at an early stage after cerebral stroke].

Introduction: Cerebral stroke can lead both to the limitation of motor skills and cognitive dysfunctions as well as mood disorders. One of the most frequent results of cerebral stroke is post-stroke depression (PSD). Numerous researchers have emphasized the significance of an early detection of this disorder. There is discussion concerning both its background and the methods that might be used for its evaluation. One of the scales applied for this purpose is Post Stroke Depression Rating Scale (PSDRS). Material and methods: The aim of this study was to determine the profile of depressive symptoms in patients at an early stage after stroke. The participants of the study were 43 persons who underwent cerebral stroke. The study was carried out in the course of the first week after the vascular incident. The patients were examined with the application of the PSDRS elaborated in order to determine the specific nature of post-stroke depression. Results: The results of the PSDRS applied indicate the occurrence of three factors present in the group under study. The first factor includes the symptoms related to a depressive mood, sense of guilt, apathy and suicidal thoughts; the second one is related to the impairment of emotional control, anhedonia, variation over time and a catastrophic reaction; the third factor concerns vegetative disorders and anxiety. Conclusions: The application of the PSDRS for the evaluation of depressed mood in persons in the acute phase after cerebral stroke enables the distinction of the factors covering various aspects related to post-stroke depression. This scale is a valuable tool for the evaluation of early symptoms of depression in patients in the first week after cerebral stroke.