Transient, symptomatic, post-operative, non-infectious hypodensity around the deep brain stimulation (DBS) electrode

Abstract

Post-operative edema around a deep brain stimulation (DBS) lead is a rare presentation. Post-operative edema that is symptomatic, self-limiting and not due to infection, in particular, is rarely reported as a separate entity. We aim to discuss the morphological characteristics of post-operative edema around a DBS lead with an insight into possible etiologies and management. We present eight patients with symptomatic, self-limiting peri-electrode edema post-DBS electrode implantation who presented post-operatively with distinct clinical presentations with imaging that revealed a hypodense area in the white matter surrounding the DBS electrode. Local and systemic tests for infection were negative. The edema resolved over time without surgical intervention. The etiology of the edema remains obscure. The transient nature of the edema and benign course with rapid and full resolution in all our patients cautions against any hasty decision to explant the electrode, in the absence of any obvious signs of infection.