Surgical management of adverse events associated with deep brain stimulation: A single-center experience. (March 2020)

• Record Type: Journal Article
• Authors: Nonaka, Masani; Morishita, Takashi; Yamada, Kazumichi; Fujioka, Shinsuke; Higuchi, Masa-aki; Tsuboi, Yoshio; Abe, Hiroshi; Inoue, Tooru
• Is Part Of: SAGE open medicine. Volume 8(2020)
• Publication Date: 2020-03
• Subjects: Deep brain stimulation -- adverse events -- troubleshooting; Medicine -- Periodicals; 610.5
• DOI: 10.1177/2050312120913458
• Languages: English
• ISSNs: 2050-3121

Abstract

Objectives: Deep brain stimulation is widely used to treat movement disorders and selected neuropsychiatric disorders. Despite the fact, the surgical methods vary among centers. In this study, we aimed to evaluate our own surgical complications and how we performed surgical troubleshooting. Methods: A retrospective chart review was performed to evaluate the clinical data of patients who underwent deep brain stimulation surgery and deep brain stimulation–related procedures at our center between October 2014 and September 2019. We reviewed surgical complications and how surgical troubleshooting was performed, regardless of where the patient underwent the initial surgery. Results: A total of 92 deep brain stimulation lead implantation and 43 implantable pulse generator replacement procedures were performed. Among the 92 lead implantation procedures, there were two intracranial lead replacement surgeries and one deep brain stimulation lead implantation into the globus pallidus to add to existing deep brain stimulation leads in the bilateral subthalamic nuclei. Wound revision for superficial infection of the implantable pulse generator site was performed in four patients. There was neither intracerebral hemorrhage nor severe hardware infection in our series of procedures. An adaptor (extension cable) replacement was performed due to lead fracture resulting from a head trauma in two cases. Conclusion: We report our experience of surgical management of adverse events associated with deep brain stimulation therapy with clinical vignettes. Deep brain stimulation surgery is a safe and effective procedure when performed by a trained neurosurgeon. It is important for clinicians to be aware that there are troubles that are potentially manageable with optimal surgical treatment.