title: Successful subthalamic nucleus deep brain stimulation therapy after significant lead displacement from a subdural hematoma.
abstract: A 57-year-old man with a 21 year history of Parkinson's disease underwent bilateral subthalamic nucleus deep brain stimulation (DBS) placement. One week postoperatively he developed an acute left subdural hematoma from a fall with significant displacement of the DBS leads. It was promptly evacuated, the patient slowly recovered neurologically, and the leads again moved near to the original position. Six months of stimulation therapy attained 50% reduction in symptoms. This case report demonstrates the movement of DBS leads due to brain shift and their ability to come back to previous location once the brain shift is corrected.
authors.affiliation: Mercy Brain and Spine, Mercy Medical Center, 1111 6th Avenue, East Tower, B level, Des Moines, IA 50314, USA. Electronic address: ehenderson@mercydesmoines.org.
authors.forename: Esmiralda Yeremeyeva
authors.initials: EY
authors.lastname: Henderson
authors.affiliation: MRI Interventions, Irvine, CA, USA.
authors.forename: Timothy
authors.initials: T
authors.lastname: Goble
authors.affiliation: Department of Electrical Engineering & Computer Science, Vanderbilt University, Nashville, TN, USA.
authors.forename: Pierre-François
authors.initials: PF
authors.lastname: D'Haese
authors.affiliation: Department of Electrical Engineering & Computer Science, Vanderbilt University, Nashville, TN, USA.
authors.forename: Srivatsan
authors.initials: S
authors.lastname: Pallavaram
authors.affiliation: Department of Neurological Surgery, Children's National Medical Center, Washington, DC, USA.
authors.forename: Chima
authors.initials: C
authors.lastname: Oluigbo
authors.affiliation: Department of Neurological Surgery, Center for Neuromodulation, Wexner Medical Center at the Ohio State University, Columbus, OH, USA.
authors.forename: Punit
authors.initials: P
authors.lastname: Agrawal
authors.affiliation: Department of Neurology, Center for Neuromodulation, Wexner Medical Center at the Ohio State University, Columbus, OH, USA.
authors.forename: Milind
authors.initials: M
authors.lastname: Deogaonkar
authors.affiliation: Department of Neurology, Center for Neuromodulation, Wexner Medical Center at the Ohio State University, Columbus, OH, USA.
authors.forename: Ali
authors.initials: A
authors.lastname: Rezai
mesh_terms: D046690:Deep Brain Stimulation / Q000379:methods*; D004567:Electrodes, Implanted; D004868:Equipment Failure; D006408:Hematoma, Subdural / Q000150:complications* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000601:surgery; D020127:Recovery of Function; D012086:Reoperation; D020531:Subthalamic Nucleus; D013396:Suction; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Deep brain stimulation; Electrode displacement; Lead displacement; Lead shift; Subdural hematoma