Complications and results of subdural grid electrode implantation in epilepsy surgery

Abstract

Background: We assessed the risk of delayed subdural hematoma and other complications associated with subdural grid implantation.

Methods: Forty-nine patients underwent subdural grid implantation with/without subdural strips or depth electrodes from January 1994 to August 1998. To identify the risk associated with subdural grid implantation, a retrospective review of all patients' medical records and radiological studies was performed.

Results: The major complications of 50 subdural grid electrode implantations were as follows: four cases (7.8%) of delayed subdural hematoma at the site of the subdural grid, requiring emergency operation; two cases (3.9%) of infection; one case (2.0%) of epidural hematoma; and one case (2.0%) of brain swelling. After subdural hematoma removal, the electrodes were left in place. CCTV monitoring and cortical stimulation studies were continued thereafter. No delayed subdural hematoma has occurred since routine placement of subdural drains was begun.

Conclusions: In our experience the worst complication of subdural grid implantation has been delayed subdural hematoma. Placement of subdural drains and close observation may be helpful to prevent this serious complication.