Lacunar infarct during pallidotomy: case report.
A symptomatic lacunar infarct is an unusual complication which may develop during stereotactically guided pallidotomy using radiofrequency thermoablation. We describe a 54-year-old man with Parkinson's disease involving predominantly the right side, progressively deteriorating under medical management. He underwent stereotactically guided radiofrequency thermoablation of the posteroventral globus pallidus interna. Despite intraoperative microelectrode recording and stimulation, the patient developed right facial weakness and pronator drift during the procedure. MRI showed a small lacunar infarct in the left internal capsule, in addition to the appropriately placed ablative lesion. We discuss the potential mechanisms for this type of injury.
Christoforidis
G A
GA
Department of Radiology, Ohio State University Medical Center, 168 Means Hall, 1654 Upham Drive, Columbus, OH 43210, USA. gchristofo@aol.com
Spickler
E M
EM
Papaioannou
G
G
Junn
F
F
D020520:Brain Infarction / Q000175:diagnosis / Q000209:etiology*; D017115:Catheter Ablation; D005917:Globus Pallidus / Q000473:pathology / Q000601:surgery*; D006801:Humans; D020772:Internal Capsule / Q000293:injuries / Q000473:pathology; D007431:Intraoperative Complications; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000601:surgery*; D013238:Stereotaxic Techniques