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Analysis of Delayed Intracerebral Hemorrhage Associated with Deep Brain Stimulation Surgery.

Authors
 Chang Kyu Park  ;  Na Young Jung  ;  Minsoo Kim  ;  Jin Woo Chang 
Citation
 WORLD NEUROSURGERY, Vol.104 : 537-544, 2017 
Journal Title
WORLD NEUROSURGERY
ISSN
 1878-8750 
Issue Date
2017
MeSH
Adolescent ; Adult ; Aftercare ; Aged ; Brain Infarction/diagnostic imaging ; Brain Infarction/etiology ; Cerebral Hemorrhage/diagnostic imaging ; Cerebral Hemorrhage/etiology* ; Child ; Deep Brain Stimulation/adverse effects* ; Dystonia/surgery* ; Essential Tremor/surgery* ; Female ; Humans ; Intracranial Hypertension/diagnostic imaging ; Intracranial Hypertension/etiology ; Male ; Middle Aged ; Obsessive-Compulsive Disorder/surgery* ; Parkinson Disease/surgery* ; Postoperative Complications/diagnostic imaging ; Postoperative Complications/etiology* ; Time Factors ; Tomography, X-Ray Computed ; Young Adult
Keywords
Complication ; Deep brain stimulation ; Intracerebral hemorrhage ; Venous infarction
Abstract
OBJECTIVE:

Deep brain stimulation (DBS) may cause various complications including intracerebral hemorrhage (ICH). Because ICH causes devastating neurologic outcomes, various surgical techniques are attempting to reduce the chances of ICH. More importantly, early detection and proper management of postoperative ICH are indispensable. ICH may occur immediately or delayed following DBS; in this study, we analyzed the clinical features of delayed ICH after DBS.

METHODS:

Patients (n = 272) underwent postoperative brain computed tomography (CT) immediately after and 1 day after DBS between January 2008 and November 2016. Among these patients, 136 patients had Parkinson disease, 54 suffered from dystonia, 47 presented with essential tremor, and 9 had obsessive-compulsive disorder.

RESULTS:

Out of the 272 patients who underwent 448 DBS lead implantations, 13 patients showed postoperative ICH. The ICH rate was 2.9% per lead and 4.77% per patient during the study period. Three patients (1.1%) demonstrated ICH immediately after DBS, and 10 patients (3.7%) demonstrated delayed ICH. Among them, only 1 patient showed large ICH (30 cm3) with elevation of intracranial pressure, subsequently undergoing ICH removal surgery and recovering without permanent neurologic deficits. The other 12 patients demonstrated small ICH (1-10 cm3). None of the patients with ICH demonstrated permanent disability.

CONCLUSIONS:

Our study demonstrates that delayed ICH can occur after DBS even with normal brain CT immediately after DBS. Because ICH can cause serious neurological sequelae, the possibility of delayed ICH after DBS should be considered for the optimal management of patients.
Full Text
https://www.sciencedirect.com/science/article/pii/S187887501730774X
DOI
10.1016/j.wneu.2017.05.075
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Minsoo(김민수)
Park, Chang Kyu(박창규)
Chang, Jin Woo(장진우) ORCID logo https://orcid.org/0000-0002-2717-0101
Jung, Na Young(정나영)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/161716
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