gms | German Medical Science

59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

01. - 04.06.2008, Würzburg

Surgical complications in deep brain stimulation of the subthalamic nucleus for Parkinson's disease – experience from a single centre

Meeting Abstract

  • corresponding author C. Fronda - Clinica Neurochirurgica, Università di Torino e A.S.O. San Giovanni Battista, Molinette, Torino
  • P. P. Panciani - Clinica Neurochirurgica, Università di Torino e A.S.O. San Giovanni Battista, Molinette, Torino
  • L. Lopiano - Clinica Neurologica, Università di Torino e A.S.O. San Giovanni Battista, Molinette, Torino
  • M. Zibetti - Clinica Neurologica, Università di Torino e A.S.O. San Giovanni Battista, Molinette, Torino
  • M. Lanotte - Clinica Neurochirurgica, Università di Torino e A.S.O. San Giovanni Battista, Molinette, Torino
  • A. Ducati - Clinica Neurochirurgica, Università di Torino e A.S.O. San Giovanni Battista, Molinette, Torino

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocDI.07.07

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2008/08dgnc195.shtml

Veröffentlicht: 30. Mai 2008

© 2008 Fronda 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 vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Deep brain stimulation of the subthalamic nucleus is an effective treatment for advanced Parkinson's disease. Several studies have reported both short- and long-term improvements of Unified Parkinson's Disease Rating Scale (UPDRS) motor scores in the medication OFF condition ranging from 40 to 70%. The most frequent complications related to the procedure are: intracerebral hemorrhage (1,2-6%), infections (2,5-15%), lead misplacement (12,5%), hardware related complications, as lead fracture and lead migration, skin erosions, CSF leak, battery failures (overall up to 26%). The object of this study was to assess the surgery-related and hardware-related complications of deep brain stimulation of the subthalamic nucleus at a single centre.

Methods: A total of 145 consecutive patients underwent bilateral deep brain stimulation device implantation in the subthalamic nucleus between 1998 and 2007 (290 procedures).

Results: The surgical complications observed were: a seroma in the site of implant of the IPG requiring the removal of the generator and a later reimplantation (0,7% of patients), one lead misplacement (0.35% of leads) and isolated seizure in two patients (1,4%). No patient had post-operative neurological deficit. All patients underwent post-operative CT and/or MRI scan, no post-operative hemorrhage was detected. One patient (0,7%) presented severe pneumocephalus with psychomotor agitation that required sedation and intubation. No infection occurred. Hardware-related complications were: migration of the lead-extension connector without skin erosion in one patient (0,7%), with subsequent replacement of the connector; IPG malfunctioning in one patient for a generator failure (0,7%).

Conclusions: In our experience DBS has proven to be a safe procedure for the treatment of advanced Parkinson's disease. Important complications determining serious deficits are rare and several of the potential hardware-related complications may be avoidable with increased surgical experience.