Hemorrhagic Complications of Microelectrode-Guided Deep Brain StimulationBinder D.K. · Rau G. · Starr P.A.
aDepartment of Neurological Surgery, University of California, and bParkinson’s Disease Research Education and Clinical Center, SanFranciscoVA Medical Center, San Francisco, Calif., USA
Background: The incidence of intracranial hemorrhage occurring during microelectrode-guided implantation of deep brain stimulators (DBS) for movement disorders has not been well defined. We report the incidence of hemorrhage in a large series of DBS implants into the subthalamic nucleus (STN), thalamus (VIM) and internal globus pallidus (GPi). Methods: All DBS procedures performed by a single surgeon (P.A.S.) between June 1998 and April 2003 were included in this study. Patients had postoperative imaging (MRI or CT) 4–24 h following surgery, and all hematomas >0.2 cm3 in volume were noted and scored as symptomatic (associated with any new neurologic deficit lasting >24 h) or asymptomatic. Results: The total number of lead implants was 357. There were 5 symptomatic hematomas and 6 asymptomatic hematomas. The relative risk of hematoma (any type) per lead implant was 3.1%. The incidence of hematoma by target site was 2.5% per lead for STN-DBS, 6.7% for GPi-DBS and 0% for VIM-DBS. Conclusion: The overall risk of intraoperative or early postoperative symptomatic hemorrhage with microelectrode-guided DBS, over all targets, was 1.4% per lead implant. The brain target had a significant effect on the risk of hemorrhage.
Devin K. Binder, M779 Moffitt Hospital, Box 0112
Dept of Neurological Surgery, University of California
San Francisco, CA 94143-0112 (USA)
Tel. +1 415 476 1087, Fax +1 415 753 1772
Number of Print Pages : 4
Number of Figures : 0, Number of Tables : 3, Number of References : 4
Stereotactic and Functional Neurosurgery
Founded 1938 as ‘Confinia Neurologica’ by E.A. Spiegel; Continued 1975–1988 as ‘Applied Neurophysiology’
Official Journal of the World Society for Stereotactic and Functional Neurosurgery; Official Journal of the American Society for Stereotactic and Functional Neurosurgery
Vol. 80, No. 1-4, Year 2003 (Cover Date: Released January 2004)
Journal Editor: D.W. Roberts, Lebanon, N.H.; Ph.L. Gildenberg, Houston, Tex.
ISSN: 1011–6125 (print), 1423–0372 (Online)
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