title: Intracerebral abscess: a rare complication of Deep Brain Stimulation.
abstract: BACKGROUND
  Deep Brain Stimulation (DBS) is a therapeutic option for some forms of Parkinson's disease (PD). The main adverse effects of this surgery are: infection (2-9%), haemorrhage (1-4%) and seizures (1-3%). We report a rare complication of DBS: an intracranial abscess.
  
  
  METHODS
  A 59-year-old male who had suffered PD for 19 years was submitted to bilateral subthalamic nucleus DBS in September 2003, when he was 52. One month later, he developed an inflammatory reaction of the skin and subcutaneous tissue surrounding the area of the subcutaneous DBS system. No infectious agent was isolated. In the following 12 months he required 5 major surgeries due to a process of systematic inflammation/infection throughout different locations of the DBS system. A few days after removal of the DBS device, he developed a right oculomotor nerve paresis and mild left hemiparesis. A CT scan revealed an abscess in the right thalamo-mesencephalic area. Both the new neurological deficits and the previous tremor and rigidity improved after surgical drainage and medical treatment.
  
  
  CONCLUSIONS
  This case report illustrates a rare complication of DBS surgery. Nevertheless, Parkinsonism improved, probably because the abscess acted like a subthalomotomy.
authors.affiliation: Department of Neurology, Hospital de S. Sebastião, Santa Maria da Feira, Portugal. Electronic address: brandaoeva@gmail.com.
authors.forename: Eva
authors.initials: E
authors.lastname: Brandão
authors.forename: Maria José
authors.initials: MJ
authors.lastname: Rosas
authors.forename: Pedro
authors.initials: P
authors.lastname: Abreu
authors.forename: Paulo
authors.initials: P
authors.lastname: Linhares
authors.forename: Rui
authors.initials: R
authors.lastname: Vaz
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000978:Antiparkinson Agents / Q000627:therapeutic use; D001922:Brain Abscess / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D003131:Combined Modality Therapy; D046690:Deep Brain Stimulation / Q000009:adverse effects*; D020878:Device Removal; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D015840:Oculomotor Nerve Diseases / Q000209:etiology; D010291:Paresis / Q000209:etiology; D010300:Parkinson Disease / Q000188:drug therapy / Q000628:therapy; D016459:Prosthesis-Related Infections / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D013207:Staphylococcal Skin Infections / Q000150:complications; D020531:Subthalamic Nucleus; D014640:Vancomycin / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D000978:Antiparkinson Agents; D007980:Levodopa; D014640:Vancomycin