gms | German Medical Science

64th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

26 - 29 May 2013, Düsseldorf

Prevention of surgical morbidity in deep brain stimulation surgery

Meeting Abstract

  • Silvia Johannes - Neurochirurgische Klinik und Poliklinik, Universitätsklinikum Würzburg
  • Almuth Kessler - Neurochirurgische Klinik und Poliklinik, Universitätsklinikum Würzburg
  • Ralf-Ingo Ernestus - Neurochirurgische Klinik und Poliklinik, Universitätsklinikum Würzburg
  • Frank Steigerwald - Neurologische Klinik und Poliklinik, Universitätsklinikum Würzburg
  • Jens Volkmann - Neurologische Klinik und Poliklinik, Universitätsklinikum Würzburg
  • Cordula Matthies - Neurochirurgische Klinik und Poliklinik, Universitätsklinikum Würzburg

Deutsche Gesellschaft für Neurochirurgie. 64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Düsseldorf, 26.-29.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. DocMI.04.07

doi: 10.3205/13dgnc307, urn:nbn:de:0183-13dgnc3075

Published: May 21, 2013

© 2013 Johannes et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: Deep brain stimulation (DBS) surgery is a well accepted treatment option in movement disorders, especially in medication refractory tremor or dystonia. Because of the complexity of their disease patients with Parkinson’s disease (PD) might be more vulnerable to surgical complications such as cardiovascular or vegetative disturbances and hemorrhages. The focus of the present study was an analysis of early and long-term surgical sequels in these subgroups.

Method: In a consecutive series of 42 patients stereotactic DBS surgery was carried out by stereotactic means including detailed MRI-planning, microrecording, semimacro-test-stimulation, macro-test-stimulation and a special mode of electrode fixation with titan mini plates. The incidence of intracerebral hemorrhage, wound infection, healing disturbances, epilepsy, confusion syndrome, psychosis, depression and long-term findings such as scar pain, cosmetic side effects and traction.

Results: DBS operations were carried out for tremor in 11, for dystonia in 14 and for PD in 16 cases. One dystonia patient experienced a seizure due to a small subdural hemorrhage; otherwise there was no intracerebral hemorrhage and no infection. One patient with PD showed an allergy to the implant material with repeated effusions along the connection cables and around the stimulator necessitating explantation of the material. Local traction effects of the connection cables are prominent in 2 patients leading to subjective disturbance in one. 3 PD patients suffered from transitory confusion syndrome with complete resolution within 2 weeks. There were no complains regarding scars or cosmetic side effects.

Conclusions: Major complications such as intracerebral bleeding or severe infection could be avoided in either treatment indication. Precise patient selection and pre-planning of surgery by the interdisciplinary team are essential elements regarding safety in this treatment modality. The only disadvantageous aspect specific in DBS for PD is the risk of temporary confusion syndrome.