Neuro-Chirurgie · 2012
[Surgical complications of deep brain stimulation: clinical experience of 184 cases].
Аннотация на английскомСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Mendes Martins V, Coste J, Derost P, Ulla M, Gabrillargues J, Durif F, Chazal J, Lemaire J-J
Аннотация
BACKGROUND AND PURPOSE: Deep brain stimulation (DBS) is an effective treatment of movement disorders and psychiatric diseases. However, this surgery is still time consuming and associated with complications, among which we aimed to identify non-stimulo-induced adverse effects. Hence, we retrospectively systematically analyzed patients operated on, at our institution, using magnetic resonance imaging (MRI) direct anatomic mapping.
METHODS: One hundred and seventy-five patients (184 surgeries) were performed between 1994 and 2008, for Parkinson's disease, essential tremor, dystonia and obsessive compulsive disorder. Primary anatomic targets were the subthalamic region, the intern pallidum and the thalamus. Final electrode positioning was adjusted according to intraoperative neuron recordings and acute stimulation tests. All surgically related adverse effects were collected. Life threatening or new non-planed surgery was considered as severe adverse effects.
RESULTS: Adverse effects occurred 10 times (5.4%) during MRI acquisition, 24 times (13%) with five serious (2.7%) including one1 death (0.5%) during electrodes implantation and 17 times (9.2%) with four serious (2.2%) during neuropacemaker implantation. Electrodes were repositioned in six cases (five patients, n=3.4%).
CONCLUSION: DBS efficiency is recognized however the significant incidence of adverse effects should prompt us to improve the procedures.
METHODS: One hundred and seventy-five patients (184 surgeries) were performed between 1994 and 2008, for Parkinson's disease, essential tremor, dystonia and obsessive compulsive disorder. Primary anatomic targets were the subthalamic region, the intern pallidum and the thalamus. Final electrode positioning was adjusted according to intraoperative neuron recordings and acute stimulation tests. All surgically related adverse effects were collected. Life threatening or new non-planed surgery was considered as severe adverse effects.
RESULTS: Adverse effects occurred 10 times (5.4%) during MRI acquisition, 24 times (13%) with five serious (2.7%) including one1 death (0.5%) during electrodes implantation and 17 times (9.2%) with four serious (2.2%) during neuropacemaker implantation. Electrodes were repositioned in six cases (five patients, n=3.4%).
CONCLUSION: DBS efficiency is recognized however the significant incidence of adverse effects should prompt us to improve the procedures.
Предметные рубрики MeSH
AdultAgedAged, 80 and overBrain MappingDeep Brain StimulationDystoniaElectrodes, ImplantedEssential TremorFemaleGlobus PallidusHumansMagnetic Resonance ImagingMaleMiddle AgedNeurosurgical ProceduresObsessive-Compulsive DisorderParkinson DiseasePostoperative ComplicationsReoperationRetrospective StudiesStereotaxic TechniquesSubthalamic NucleusThalamus