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Cerebral ischemia related to globus pallidus internus stimulation for cervical dystonia

Authors
 Kang D.W.  ;  Kim H.Y.  ;  Chang J.W. 
Citation
 STEREOTACTIC AND FUNCTIONAL NEUROSURGERY, Vol.89(4) : 201-204, 2011 
Journal Title
STEREOTACTIC AND FUNCTIONAL NEUROSURGERY
ISSN
 1011-6125 
Issue Date
2011
MeSH
Adult ; Brain Ischemia/etiology* ; Deep Brain Stimulation/adverse effects* ; Globus Pallidus/physiopathology* ; Globus Pallidus/surgery ; Humans ; Male ; Microelectrodes/adverse effects* ; Torticollis/therapy*
Keywords
Complications ; Deep brain stimulation ; Dystonia ; Globus pallidus ; Ischemia
Abstract
BACKGROUND: Deep brain stimulation (DBS) is generally a safe and effective method to treat intractable movement disorders. However, complications of surgery have been reported, such as hemorrhage, infection and hardware failure.

OBJECTIVES AND METHODS: We describe an unusual complication associated with DBS of the globus pallidus internus (GPi). The patient was a 34-year-old man with a 5-year history of progressive cervical dystonia that was unresponsive to medical treatment. He underwent bilateral DBS of the posteroventral GPi. After test stimulation, the patient developed left facial weakness, as well as dysarthria and hemiparesis of the left side. Magnetic resonance imaging showed a small infarct in the right posterior internal capsule. There was no misplacement of the microelectrode.

RESULTS AND CONCLUSION: The authors present this unique case of cerebral infarction as a complication of DBS. The mechanism of ischemia is unclear. However, in this case, we had performed microstimulation with high amplitude in order to determine the adverse effects. This magnitude of electrical stimulation may have led to small-vessel vasospasm, which may have induced ischemia. Although ischemia after DBS surgery is seldom reported, cerebral ischemia may be a surgical complication after DBS implantation.
Full Text
http://www.karger.com/Article/FullText/325655
DOI
10.1159/000325655
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Dong Wan(강동완)
Kim, Hae Yu(김해유)
Chang, Jin Woo(장진우) ORCID logo https://orcid.org/0000-0002-2717-0101
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/94830
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