Subdural electrode-associated complications: a 20-year experience.
BACKGROUND
Implantation of subdural strip and grid electrodes is a common methodology in the invasive evaluation of patients with medically refractory epilepsy. Although their implantation is safe, the occurrence of implantation-associated complications can occasionally be troublesome.


METHODS
In our current retrospective study, 185 patients undergoing subdural grid/strip implantation for invasive monitoring were examined. Their ages ranged between 16 and 48 years (mean 23.6). AdTech (Racine, Wisc., USA) strip and grid electrodes were implanted under general endotracheal anesthesia in all our cases. Duration of electroencephalographic monitoring ranged from 2 to 25 days (mean 10.8). The follow-up period ranged from 24 to 60 months (mean 44.6 months).


RESULTS
The most common complication in our series was the development of postoperative epidural hematoma in 3 patients (1.6%), while 2 patients (1.1%) suffered a subdural hematoma. Two patients (1.1%) developed significant brain edema postoperatively, 2 others (1.1%) developed an infection, while 2 patients (1.1%) experienced transient aphasia. Two patients (1.1%) had fatal outcomes in our series. Interestingly, in 5 patients (2.7%) nonhabitual seizures were recorded.


CONCLUSIONS
Thorough understanding, early identification and prompt management of potential complications can minimize the risks associated with the implantation of subdural electrodes.
Fountas
Kostas N
KN
Department of Neurosurgery, Medical College of Georgia, Augusta, GA, USA. knfountasmd@excite.com
Smith
Joseph R
JR
D000293:Adolescent; D000328:Adult; D001037:Aphasia / Q000209:etiology; D001929:Brain Edema / Q000209:etiology; D003428:Cross Infection / Q000209:etiology; D004567:Electrodes, Implanted / Q000009:adverse effects*; D004569:Electroencephalography; D004827:Epilepsy / Q000175:diagnosis*; D005260:Female; D005500:Follow-Up Studies; D006407:Hematoma, Epidural, Cranial / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013355:Subdural Space