title: Cerebral ischemia related to globus pallidus internus stimulation for cervical dystonia.
abstract: BACKGROUND
  Deep brain stimulation (DBS) is generally a safe and effective method to treat intractable movement disorders. However, complications of surgery have been reported, such as hemorrhage, infection and hardware failure.
  
  
  OBJECTIVE
  We describe an unusual complication associated with DBS of the globus pallidus internus (GPi). The patient was a 34-year-old man with a 5-year history of progressive cervical dystonia that was unresponsive to medical treatment. He underwent bilateral DBS of the posteroventral GPi. After test stimulation, the patient developed left facial weakness, as well as dysarthria and hemiparesis of the left side. Magnetic resonance imaging showed a small infarct in the right posterior internal capsule. There was no misplacement of the microelectrode.
  
  
  CONCLUSIONS
  The authors present this unique case of cerebral infarction as a complication of DBS. The mechanism of ischemia is unclear. However, in this case, we had performed microstimulation with high amplitude in order to determine the adverse effects. This magnitude of electrical stimulation may have led to small-vessel vasospasm, which may have induced ischemia. Although ischemia after DBS surgery is seldom reported, cerebral ischemia may be a surgical complication after DBS implantation.
authors: Department of Neurosurgery, Yonsei University School of Medicine, Seoul, Republic of Korea.
authors: Dong Wan
authors: DW
authors: Kang
authors: Hae Yu
authors: HY
authors: Kim
authors: Jin Woo
authors: JW
authors: Chang