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Vol. 89, No. 2, 2011
Issue release date: April 2011
Section title: Clinical Study
Stereotact Funct Neurosurg 2011;89:76–82
(DOI:10.1159/000323335)

Incidence and Management of Venous Air Embolisms during Awake Deep Brain Stimulation Surgery in a Large Clinical Series

Chang E.F. · Cheng J.S. · Richardson R.M. · Lee C. · Starr P.A. · Larson P.S.
Department of Neurological Surgery, University of California, San Francisco, San Francisco, Calif., USA

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Article / Publication Details

First-Page Preview
Abstract of Clinical Study

Received: 8/12/2010
Accepted: 11/28/2010
Published online: 2/2/2011

Number of Print Pages: 7
Number of Figures: 3
Number of Tables: 2

ISSN: 1011-6125 (Print)
eISSN: 1423-0372 (Online)

For additional information: http://www.karger.com/SFN

Abstract

Background/Aims: Venous air embolism (VAE) is a potential complication during neurosurgical procedures, particularly in the sitting position. The diagnosis and management of VAE in patients undergoing awake deep brain stimulation (DBS) lead implantation in the sitting position are underreported. Methods: We performed a retrospective chart review of 467 consecutive DBS surgeries at the University of California, San Francisco. Data was collected for patient demographics, diagnosis, intraoperative events, and postoperative course. Results: Six cases of clinically diagnosed VAE were found, amounting to a total incidence of 1.3% per procedure. We did not observe a statistical association with patient age, diagnosis, or DBS target. The most common symptoms of intraoperative VAE were coughing, oxygen desaturation, and hypotension. In all cases, VAE was treated by copious irrigation of the surgical field and lowering the patient’s head. In 4 cases, DBS implantation was abandoned because of ongoing symptoms of VAE. The respiratory outcome in all patients was good after several days of close observation. Conclusion: The incidence of VAE during DBS procedures is small, but prompt recognition and management of VAE are critical to avoid further associated complications.


Article / Publication Details

First-Page Preview
Abstract of Clinical Study

Received: 8/12/2010
Accepted: 11/28/2010
Published online: 2/2/2011

Number of Print Pages: 7
Number of Figures: 3
Number of Tables: 2

ISSN: 1011-6125 (Print)
eISSN: 1423-0372 (Online)

For additional information: http://www.karger.com/SFN


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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

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