Analysis of intracerebral abscesses in Deep Brain Stimulation and association with hardware-related wound complications.

BACKGROUND

Deep brain stimulation (DBS) is an effective treatment for various neurological disorders, including Parkinson's disease. However, its increasing use has highlighted the risk of serious complications, such as intracerebral abscesses and hardware-related wound infections. While hardware-related infections are common, intracerebral abscesses remain rare.

OBJECTIVE

This study presents a retrospective analysis of DBS-associated intracerebral abscesses and hardware-related wound complications, alongside an evaluation of contributing factors observed over 13 years at our DBS center.

METHODS

A total of 194 patients who underwent DBS implantation were analyzed, investigating demographics, postoperative complications, device type, and treatment outcomes. A literature review was also conducted to identify similar cases of DBS-related intracerebral infections.

RESULTS

The incidence of DBS-associated intracerebral abscess in our series was 1.54 %. All patients underwent partial or total hardware removal, and broad-spectrum antibiotic therapy was administered. The use of curved devices and vancomycin powder prophylaxis was associated with a reduction in wound complications. A higher risk of pathogen growth was found in male patients, while female patients exhibited a borderline significantly lower risk of abscess development.

CONCLUSION

Our study contributes to the limited literature on DBS-associated intracerebral abscesses. The findings underscore the importance of early diagnosis and individualized treatment, offering insights into preventing hardware-related infections and intracerebral abscesses. These results may guide future strategies for managing this rare but serious complication.