gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Implantation of subdural grid electrodes in epilepsy surgery: an operative point of view

Implantation subduraler Gridelektroden zum invasiven Monitoring: perioperative Aspekte

Meeting Abstract

  • corresponding author C. Scheiwe - Neurochirurgische Universitätsklinik, Albert-Ludwigs-Universität Freiburg
  • U. Hubbe - Neurochirurgische Universitätsklinik, Albert-Ludwigs-Universität Freiburg
  • S. Rona - Neurochirurgische Universitätsklinik, Albert-Ludwigs-Universität Freiburg
  • A. Schulze-Bonhage - Neurochirurgische Universitätsklinik, Albert-Ludwigs-Universität Freiburg
  • J. Zentner - Neurochirurgische Universitätsklinik, Albert-Ludwigs-Universität Freiburg
  • V. van Velthoven - Neurochirurgische Universitätsklinik, Albert-Ludwigs-Universität Freiburg

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc11.05.-12.04

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2005/05dgnc0236.shtml

Veröffentlicht: 4. Mai 2005

© 2005 Scheiwe et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

In epilepsy surgery, invasive monitoring using subdural grid electrodes is performed to determine the epileptogenic zone and define functional brain areas. We evaluated whether there are predictors for possible perioperative complications.

Methods

530 Patients underwent epilepsy-surgery in our department from 1998 to 2004. In 130 Patients (25%), craniotomy for implantation of subdural grid electrodes was performed. The perioperative course from grid implantation to resection procedure and the operative nuances were analysed.

Results

In our series of 130 craniotomies for invasive monitoring, 13 (10%) grid electrodes were removed without resection, because seizure origin was either multilocular or located in functional areas. Operative revision was necessary in 4 cases (3%): Correction of electrode position was performed in two cases. One evacuation of epidural haematoma was necessary without grid removal. One chronic subdural haematoma was operated 2 weeks after grid-implantation. Fixation of grid-electrodes to the dura could not avoid subdural haematoma in 2 cases (1,5%) and led to haematoma under the grid which impaired mapping in 2 other cases (1,5%). These resections were performed with neuronavigation and electrocorticography. In about 10% of the implantations clinical deterioration due to subdural haematoma forced an accelerated mapping and following resection. However, all resections could be carried out as planned. Negative predictors for subdural haematoma in our series are: Re-Craniotomy, Large grid-electrodes (64 or 112 contacts), Electrode-position in the midline.

Conclusions

Implantation of subdural grid electrodes for invasive monitoring leads to surgical resection in 90%. The complication rate is low (6% minor complications, no major complication) and there was no manifest infection, but subdural haematoma could not be avoided in all cases.