Symptomatic Cystic Lesion Following Deep Brain Stimulation Surgery

2020 ◽  
pp. 37-40
Author(s):  
Vibhash D. Sharma ◽  
Shilpa Chitnis
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Rare Complication ◽  
Cyst Formation ◽  
Management Options ◽  
Unexplained Symptoms ◽  
The Common ◽  
Deep Brain Stimulation Surgery ◽  
Deep Brain

Deep brain stimulation therapy is an effective therapy for selected patients with movement disorders. The procedure is relatively safe, but complications related to the surgical procedure or implanted hardware can occur. The common complications include hemorrhage, infarct, infection, and confusion. Noninfectious cyst formation around the DBS lead is a rare but potential complication of this procedure, which can occur several weeks to months after DBS lead implantation. This chapter describes a case of noninfectious cyst formation at the tip of DBS lead in a patient with essential tremor. Clinical presentation, role of imaging, and the management options for this rare complication are discussed. This case also illustrates the importance of post-DBS imaging in suspected cases with new or unexplained symptoms.

Using imaging to identify psychogenic parkinsonism before deep brain stimulation surgery

2012 ◽  
Vol 116 (1) ◽  
pp. 114-118 ◽  
Author(s):  
Michael H. Pourfar ◽  
Chris C. Tang ◽  
Alon Y. Mogilner ◽  
Vijay Dhawan ◽  
David Eidelberg
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Metabolic Networks ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Number Of Patients ◽  
Normal Expression ◽  
Deep Brain Stimulation Surgery ◽  
Deep Brain

The frequency with which patients with atypical parkinsonism and advanced motor symptoms undergo deep brain stimulation (DBS) procedures is unknown. However, the potential exposure of these patients to unnecessary surgical risks makes their identification critical. As many as 15% of patients enrolled in recent early Parkinson disease (PD) trials have been found to lack evidence of a dopaminergic deficit following PET or SPECT imaging. This suggests that a number of patients with parkinsonism who are referred for DBS may not have idiopathic PD. The authors report on 2 patients with probable psychogenic parkinsonism who presented for DBS surgery. They found that both patients had normal caudate and putamen [18F]-fluorodopa uptake on PET imaging, along with normal expression of specific disease-related metabolic networks for PD and multiple system atrophy, a common form of atypical neurodegenerative parkinsonism. The clinical and PET findings in these patients highlight the role of functional imaging in assisting clinical decision making when the diagnosis is uncertain.

scholarly journals Role ofTc-Sulesomab Immunoscintigraphy in the Management of Infection following Deep Brain Stimulation Surgery

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Raquel Real ◽  
Paulo Linhares ◽  
Hélder Fernandes ◽  
Maria José Rosas ◽  
Miguel F. Gago ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Potential Role ◽  
Antibody Fragments ◽  
Conservative Approach ◽  
Serious Adverse Event ◽  
Deep Brain Stimulation Surgery ◽  
Antigranulocyte Antibody ◽  
Deep Brain

Infection constitutes a serious adverse event in patients submitted to deep brain stimulation, often leading to removal of the device. We set to evaluate the potential role of immunoscintigraphy withTc-labelled antigranulocyte antibody fragments (Tc-sulesomab) in the management of infection following DBS.Tc-sulesomab immunoscintigraphy seems to correlate well with the presence and extent of infection, thus contributing to differentiate between patients who should remove the hardware entirely at presentation and those who could undergo a more conservative approach. Also,Tc-sulesomab immunoscintigraphy has a role in determining the most appropriate timing for reimplantation. Finally, we propose an algorithm for the management of infection following DBS surgery, based on the results of theTc-sulesomab immunoscintigraphy.

Deep brain stimulation in headache

Cephalalgia ◽  
2016 ◽  
Vol 36 (12) ◽  
pp. 1143-1148 ◽  
Author(s):  
Massimo Leone ◽  
Alberto Proietti Cecchini
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Chronic Cluster Headache ◽  
Hypothalamic Stimulation ◽  
Hypothalamic Area ◽  
Unilateral Headache ◽  
Randomised Controlled ◽  
Invasive Neurostimulation ◽  
Deep Brain

Background: Deep brain stimulation of the posterior hypothalamic area was first introduced in 2000 to treat drug-refractory chronic cluster headache (CH). Findings: So far, hypothalamic stimulation has been employed in 79 patients suffering from various forms of intractable short-lasting unilateral headache forms, mainly trigeminal autonomic cephalalgias. The majority were (88.6%) chronic CH, including one patient who suffered from symptomatic chronic CH-like attacks; the remaining were short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT), one had paroxysmal hemicranias and one symptomatic trigeminal neuralgia. Overall, after a mean follow up of 2.2 years, 69.6% (55) hypothalamic-stimulated patients showed a ≥50% improvement. Conclusions: These observations need confirmation in randomised, controlled trials. A key role of the posterior hypothalamic area in the pathophysiology of unilateral short-lasting headaches, possibly by regulating the duration rather than triggering the attacks, can be hypothesised. Because of its invasiveness, hypothalamic stimulation can be proposed only after other, less-invasive, neurostimulation procedures have been tried.

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