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55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

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Surgical complications of deep brain stimulation for movement disorders

Operative Komplikationen der Tiefenhirnstimulation in der Therapie von Bewegungsstörungen

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  • corresponding author Marcus Otto Pinsker - Department of Neursurgery at the University of Kiel, Kiel
  • B. Schrader - Department of Neursurgery at the University of Kiel, Kiel
  • W. Hamel - Department of Neursurgery at the University of Kiel, Kiel
  • J. Volkmann - Department of Neurology at the University of Kiel, Kiel
  • D. Müller - Department of Neurosurgery, University Hospital Hamburg-Eppendorf, Hamburg
  • H. M. Mehdorn - Department of Neursurgery at the University of Kiel, Kiel

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocDI.06.03

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2004/04dgnc0204.shtml

Published: April 23, 2004

© 2004 Pinsker et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective

The aim of this study was to define the incidence of surgical complications of deep brain stimulation (DBS) in patients with movement disorders.

Methods

The authors retrospectively reviewed the cases of 110 procedures on 104 consecutive patients (64 male, 40 female, median age 61 years, range 27-73 years) who underwent implantation of 210 deep brain stimulation electrodes (bilateral n=100; unilateral n=10) between January 1999 to December 2002 with a follow-up of at least 6 months. Underlying disease was Parkinson’s disease in 79 cases, tremor in 19 cases and dystonia in 6 cases. Implantation sites were as follows: subthalamic nucleus (STN) n=81, ventral intermediate nucleus (VIM) n=23, globus pallidus internus (GPi) n=6.

Results

Five clinically evident hemorrhages occurred during the implantation of 210 electrodes (2.3%) requiring surgical intervention (subdural hematoma n=1, epidural hematoma n=2, intracerebral hematoma n=1, venous infarction with secondary hemorrhage n=1) in the first part of the series. Mortality was 0.9% (n=1 intracerebral hemorrhage, n=1 resuscitation due to acute respiratory insufficiency). Operation had to be interrupted in 6 patients (hemorrhage n=3, disturbance of ventilation n=2, intraoperative psychosis n=1). While no infection of the hardware occurred, other complications were dislocation of the hardware (n=3), pain at the site of the stimulation device (n=1), scar formation at the electrodes (n=1). Revision of the hardware was necessary in 6 patients (2.8%).

Conclusions

Although complications of DBS surgery performed for treatment of movement disorders are rare, some of them can be serious and even fatal. Therefore a careful patient selection and informed consent is crucial, combined with experienced intraoperative surgical routine in high-load centers.