الفهرس 
ANATOMY OF CENTRAL N ERVOUS SYSTEMOnly 14 pages are availabe for public view
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Abstract
Brain tumors represent a group of neoplasms arising from brain tissue, each with their own unique biology, prognosis, and treatment. Included in this group are neoplasms not arising from brain parenchyma, which encompass meningiomas, lymphomas, and metastatic disease from other primary sources (often referred to as secondary brain tumors). Despite the diverse group of neoplasms represented, most intracranial tumors follow similar clinical presentations and diagnostic workup.
Patients with supratentorial lesions in proximity to the eloquent cortex had better neurological outcome and maximal tumor removal with awake craniotomy (AC) than surgery under general anesthesia (GA). AC provides a feasible alternative to craniotomy under GA.
Scalp block has a steep learning curve and its practice will undoubtedly help the anesthesiologist in the perioperative management of patients undergoing craniotomy.
The application of awake craniotomy has been continually evolving. The success of each different anesthetic technique depends on proper preoperative preparation, proper anesthetic technique, proper choice of anesthetic agents and immediate management of complications. Modern anesthetic approaches may be divided as follows: Monitored anesthesia care (MAC) and asleep- awake -asleep (AAA) and recently a new approach of awake-awake-awake technique.
Many case reports for AC were published around the world. Clinical studies in specific groups such as children and pregnant women were done. Many retrospective studies are still needed for better assessment for AC.
There is increasing evidence that an awake craniotomy would be an appropriate choice for removal of all supratentorial lesions nonselectively. It can maximize lesion resection, which can be linked to improved survival rates, and has low complication rates.