Skip to main content
Erschienen in: Acta Neurochirurgica 9/2017

24.06.2017 | Original Article - Functional

Delayed complications of deep brain stimulation: 16-year experience in 249 patients

verfasst von: Gustavo Fernández-Pajarín, A. Sesar, B. Ares, J. L. Relova, E. Arán, M. Gelabert-González, A. Castro

Erschienen in: Acta Neurochirurgica | Ausgabe 9/2017

Einloggen, um Zugang zu erhalten

Abstract

Background

Over the years, most of the deep brain stimulation (DBS) complications described have been mainly related to the surgery itself or the stimulation. Only a few authors have dealt with chronic complications or complications due to implanted material.

Methods

We retrospectively analyzed complications beyond the 1st month after surgery in 249 patients undergoing DBS at our site for 16 years, with 321 interventions overall.

Results

Our results show that infection is the most frequent delayed complication (12.5%), the pulse generator being the most common location. Lead breaks (9.3%) are the second most frequent complication. Symptomatic peri-lead edema and cyst formation were exceptional.

Conclusions

The best knowledge about DBS complications allows for better solutions. In case of infection, conservative treatment or partial removal of the DBS system appears to be safe and reasonable. Intracranial complications related to DBS material such as peri-lead edema and cyst formation have a good prognosis. They may appear long after DBS implantation.
Literatur
1.
Zurück zum Zitat Benabid AL, Chabardes S, Mitrofanis J, Pollak P (2009) Deep brain stimulation of the subthalamic nucleus for the treatment of Parkinson’s disease. Lancet Neurol 8:67e81CrossRef Benabid AL, Chabardes S, Mitrofanis J, Pollak P (2009) Deep brain stimulation of the subthalamic nucleus for the treatment of Parkinson’s disease. Lancet Neurol 8:67e81CrossRef
2.
Zurück zum Zitat Boviatsis EJ, Stavrinou LC, Themistocleous M, Kouyialis AT, Sakas DE (2010) Surgical and hardware complications of deep brain stimulation. A seven-year experience and review of the literature. Acta Neurochir 152:2053–3062CrossRefPubMed Boviatsis EJ, Stavrinou LC, Themistocleous M, Kouyialis AT, Sakas DE (2010) Surgical and hardware complications of deep brain stimulation. A seven-year experience and review of the literature. Acta Neurochir 152:2053–3062CrossRefPubMed
3.
Zurück zum Zitat Castro Bouzas D, Serramito García R, Relova Quinteiro JL, Castro García A, Ares Pensado B, Sesar Ignacio A, Gelabert-Gonzalez M (2013) Bowstringing as a complication of deep brain stimulation. Neurocirugia (Astur) 24(1):37–40CrossRef Castro Bouzas D, Serramito García R, Relova Quinteiro JL, Castro García A, Ares Pensado B, Sesar Ignacio A, Gelabert-Gonzalez M (2013) Bowstringing as a complication of deep brain stimulation. Neurocirugia (Astur) 24(1):37–40CrossRef
4.
Zurück zum Zitat Deogaonkar M, Nazzaro JM, Machado A, Rezai A (2011) Transient, symptomatic, post-operative, non-infectious hypodensity around the deep brain stimulation (DBS) electrode. J Clin Neurosci 18(7):910–915CrossRefPubMed Deogaonkar M, Nazzaro JM, Machado A, Rezai A (2011) Transient, symptomatic, post-operative, non-infectious hypodensity around the deep brain stimulation (DBS) electrode. J Clin Neurosci 18(7):910–915CrossRefPubMed
5.
Zurück zum Zitat Doshi PK (2011) Long-term surgical and hardware-related complications of deep brain stimulation. Stereotact Funct Neurosurg 89(2):89–95CrossRefPubMed Doshi PK (2011) Long-term surgical and hardware-related complications of deep brain stimulation. Stereotact Funct Neurosurg 89(2):89–95CrossRefPubMed
6.
Zurück zum Zitat Englot DJ, Glastonbury CM, Larson PS (2011) Abnormal T2-weighted MRI signal surrounding leads in a subset of deep brain stimulation patients. Stereotact Funct Neurosurg 89(5):311–317CrossRefPubMed Englot DJ, Glastonbury CM, Larson PS (2011) Abnormal T2-weighted MRI signal surrounding leads in a subset of deep brain stimulation patients. Stereotact Funct Neurosurg 89(5):311–317CrossRefPubMed
7.
Zurück zum Zitat Fenoy AJ, Simpson RK (2012) Management of device-related wound complications in deep brain stimulation surgery. J Neurosurg 116:1324–1332CrossRefPubMed Fenoy AJ, Simpson RK (2012) Management of device-related wound complications in deep brain stimulation surgery. J Neurosurg 116:1324–1332CrossRefPubMed
8.
Zurück zum Zitat Follett KA, Weaver FM, Stern M, Hur K, Harris CL, Luo P, Marks WJ Jr, Rothlind J, Sagher O, Moy C, Pahwa R, Burchiel K, Hogarth P, Lai EC, Duda JE, Holloway K, Samii A, Horn S, Bronstein JM, Stoner G, Starr PA, Simpson R, Baltuch G, De Salles A, Huang GD, Reda DJ (2010) Pallidal versus Subthalamic deep-brain stimulation for Parkinson’s disease. N Engl J Med 362:2077–2091CrossRefPubMed Follett KA, Weaver FM, Stern M, Hur K, Harris CL, Luo P, Marks WJ Jr, Rothlind J, Sagher O, Moy C, Pahwa R, Burchiel K, Hogarth P, Lai EC, Duda JE, Holloway K, Samii A, Horn S, Bronstein JM, Stoner G, Starr PA, Simpson R, Baltuch G, De Salles A, Huang GD, Reda DJ (2010) Pallidal versus Subthalamic deep-brain stimulation for Parkinson’s disease. N Engl J Med 362:2077–2091CrossRefPubMed
9.
Zurück zum Zitat Geissinger G, Neal JH (2007) Spontaneous twiddler’s syndrome in a patient with a deep brain stimulator. Surg Neurol 68:454–456CrossRefPubMed Geissinger G, Neal JH (2007) Spontaneous twiddler’s syndrome in a patient with a deep brain stimulator. Surg Neurol 68:454–456CrossRefPubMed
10.
Zurück zum Zitat Jagid J, Madhavan K, Bregy A, Desai M, Ruiz A, Quencer R, Landy HJ (2015) Deep brain stimulation complicated by bilateral cystic cavitation around the leads in a patient with Parkinson’s disease. BMJ Case Rep. doi:10.1136/bcr-2015-211470 Jagid J, Madhavan K, Bregy A, Desai M, Ruiz A, Quencer R, Landy HJ (2015) Deep brain stimulation complicated by bilateral cystic cavitation around the leads in a patient with Parkinson’s disease. BMJ Case Rep. doi:10.​1136/​bcr-2015-211470
11.
12.
Zurück zum Zitat Janson C, Maxwell R, Gupte AA, Abosch A (2010) Bowstringing as a complication of deep brain stimulation: case report. Neurosurgery 66(6):E1205CrossRefPubMed Janson C, Maxwell R, Gupte AA, Abosch A (2010) Bowstringing as a complication of deep brain stimulation: case report. Neurosurgery 66(6):E1205CrossRefPubMed
13.
Zurück zum Zitat Ramirez-Zamora A, Levine D, Sommer DB, Dalfino J, Novak P, Pilitsis JG (2013) Intraparenchymal cyst development after deep brain stimulator placement. Stereotact Funct Neurosurg 91(5):338–341CrossRefPubMed Ramirez-Zamora A, Levine D, Sommer DB, Dalfino J, Novak P, Pilitsis JG (2013) Intraparenchymal cyst development after deep brain stimulator placement. Stereotact Funct Neurosurg 91(5):338–341CrossRefPubMed
14.
Zurück zum Zitat Tong F, Ramirez-Zamora A, Gee L, Pilitsis J (2015) Unusual complications of deep brain stimulation. Neurosurg Rev 38(2):245–252CrossRefPubMed Tong F, Ramirez-Zamora A, Gee L, Pilitsis J (2015) Unusual complications of deep brain stimulation. Neurosurg Rev 38(2):245–252CrossRefPubMed
Metadaten
Titel
Delayed complications of deep brain stimulation: 16-year experience in 249 patients
verfasst von
Gustavo Fernández-Pajarín
A. Sesar
B. Ares
J. L. Relova
E. Arán
M. Gelabert-González
A. Castro
Publikationsdatum
24.06.2017
Verlag
Springer Vienna
Erschienen in
Acta Neurochirurgica / Ausgabe 9/2017
Print ISSN: 0001-6268
Elektronische ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-017-3252-7

Weitere Artikel der Ausgabe 9/2017

Acta Neurochirurgica 9/2017 Zur Ausgabe

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.