Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jul 22:2018:3056018.
doi: 10.1155/2018/3056018. eCollection 2018.

Experience Reduces Surgical and Hardware-Related Complications of Deep Brain Stimulation Surgery: A Single-Center Study of 181 Patients Operated in Six Years

Mehmet Sorar  1 , Sahin Hanalioglu  1 , Bilge Kocer  2 , Muhammed Taha Eser  1 , Selim Selcuk Comoglu  2 , Hayri Kertmen  1
Affiliations

Experience Reduces Surgical and Hardware-Related Complications of Deep Brain Stimulation Surgery: A Single-Center Study of 181 Patients Operated in Six Years

Mehmet Sorar et al. Parkinsons Dis. .

Abstract

Objective: Deep brain stimulation (DBS) surgery has increasingly been performed for the treatment of movement disorders and is associated with a wide array of complications. We aimed to present our experience and discuss strategies to minimize adverse events in light of this contemporary series and others in the literature.

Methods: A retrospective chart review was conducted to collect data on age, sex, indication, operation date, surgical technique, and perioperative and late complications.

Results: A total of 181 patients (113 males, 68 females) underwent DBS implantation surgery (359 leads) in the past six years. Indications and targets were as follows: Parkinson's disease (STN) (n=159), dystonia (GPi) (n=13), and essential tremor (Vim) (n=9). Mean age was 55.2 ± 11.7 (range 9-74) years. Mean follow-up duration was 3.4 ± 1.6 years. No mortality or permanent morbidity was observed. Major perioperative complications were confusion (6.6%), intracerebral hemorrhage (2.2%), stroke (1.1%), and seizures (1.1%). Long-term adverse events included wound (7.2%), mostly infection, and hardware-related (5.5%) complications. Among several factors, only surgical experience was found to be related with overall complication rates (early period: 31% versus late period: 10%; p=0.001).

Conclusion: The rates of both early and late complications of DBS surgery are acceptably low and decrease significantly with cumulative experience.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Operative complications due to deep brain stimulation surgery. (a, b) Right caudate hematoma with intraventricular hemorrhage. (c) Venous hemorrhagic infarction around the left-sided DBS lead; (d) 6-month follow-up FLAIR MRI. (e, f) Pre- and postoperative images of the left-sided chronic subdural hematoma over the parietal cortex. Note that the frontal component of the cSDH was left intact to avoid iatrogenic injury to the lead.
Figure 2
Figure 2
Cumulative experience reduces the rate of complications following DBS surgery. The graph shows relatively constant annual caseload but remarkable reduction in the percentage of cases with complications throughout the years.
See this image and copyright information in PMC

References

    1. Benabid A. L., Chabardes S., Mitrofanis J., Pollak P. Deep brain stimulation of the subthalamic nucleus for the treatment of Parkinson’s disease. The Lancet Neurology. 2009;8(1):67–81. doi: 10.1016/s1474-4422(08)70291-6. - DOI - PubMed
    1. Miocinovic S., Somayajula S., Chitnis S., Vitek J. L. History, applications, and mechanisms of deep brain stimulation. JAMA Neurology. 2013;70(2):163–171. doi: 10.1001/2013.jamaneurol.45. - DOI - PubMed
    1. Deuschl G., Schade-Brittinger C., Krack P., et al. A randomized trial of deep-brain stimulation for Parkinson’s disease. New England Journal of Medicine. 2006;355(9):896–908. doi: 10.1056/nejmoa060281. - DOI - PubMed
    1. Weaver F. M., Follett K., Stern M., et al. Bilateral deep brain stimulation vs best medical therapy for patients with advanced Parkinson disease: a randomized controlled trial. JAMA. 2009;301(1):63–73. doi: 10.1001/jama.2008.929. - DOI - PMC - PubMed
    1. Awan N. R., Lozano A., Hamani C. Deep brain stimulation: current and future perspectives. Neurosurgical Focus. 2009;27(1):p. E2. doi: 10.3171/2009.4.focus0982. - DOI - PubMed

LinkOut - more resources