Avoidance and management of surgical and hardware-related complications of deep brain stimulation.
OBJECTIVE
Although deep brain stimulation (DBS) is nonablative, it may give rise to many complications. In order to identify and reduce factors contributing to the complications, we performed a retrospective analysis of patients who received DBS in our institution over a 9-year period from March 2000 to December 2008.


METHODS
Included in this study were 161 patients (85 male and 76 female). Data from these patients were collected and analyzed with respect to the complications and factors potentially related to these complications.


RESULTS
A total of 25 surgical and hardware-related complications occurred in 24 patients, including confusion in 11 cases (6.83%), asymptomatic intracranial hemorrhage in 1 case (0.62%), electrode misplacement in 2 cases (1.24%), infection of the subcutaneous pocket receiving the pulse generator in 1 case (0.62%), skin erosion in 2 cases (1.24%), pulse generator seroma formation in 6 cases (3.72%), and device malfunction in 1 case (0.62%). There was no permanent neurological deficit.


CONCLUSIONS
Confusion is the most common complication in simultaneous bilateral DBS targeting the subthalamic nucleus, especially in patients with severe Parkinson's disease. With increasing experience of surgeons, complete obedience to intraoperative surgical routines and reasonable application of the microelectrode recording technique, other complications could also be reduced.
Hu
Xiaowu
X
Department of Neurosurgery, Second Military Medical University, Shanghai, PR China.
Jiang
Xiufeng
X
Zhou
Xiaoping
X
Liang
Jinchuan
J
Wang
Laixing
L
Cao
Yiqun
Y
Liu
Jianmin
J
Jin
Aiguo
A
Yang
Pengfei
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003221:Confusion / Q000209:etiology; D046690:Deep Brain Stimulation / Q000009:adverse effects / Q000295:instrumentation*; D004421:Dystonia / Q000628:therapy*; D004567:Electrodes, Implanted / Q000009:adverse effects*; D020329:Essential Tremor / Q000628:therapy*; D005260:Female; D006801:Humans; D020300:Intracranial Hemorrhages / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000628:therapy*; D011475:Prosthesis Failure / Q000009:adverse effects*; D012189:Retrospective Studies; D020531:Subthalamic Nucleus / Q000601:surgery