Abstract | OBJECTIVE: The aim of this study was to determine the safety of a deep brain stimulation technique consisting of a combination of routine general anesthesia, magnetic resonance imaging direct targeting, and a single penetration technique in a large population of patients undergoing operation for movement disorders. METHODS: One hundred ninety-four patients treated with deep brain stimulation between 1996 and 2007 were assessed via a computerized database for intra- and perioperative events. Most patients were young; only 62 of them were older than 40 years (mean age, 31.1 years). General anesthesia was induced in all cases before placement of a magnetic resonance imaging-compatible stereotactic frame. Electrode implantation was done under radioscopic control via a rigid immobile cannula using a single cerebral perforation. No perioperative microelectrode recording or neurostimulation testing was used. Systematic postoperative magnetic resonance imaging was performed before frame removal. RESULTS: A total of 478 electrodes were implanted in 220 procedures: 426 for dystonic-dyskinetic syndromes and 52 for Parkinson disease. The mean number of parenchymal penetrations per patient was 2.5 for the dystonic-dyskinetic syndrome group and 2.08 for the Parkinson disease group. Postimplantation magnetic resonance imaging detected no perioperative intraparenchymal hemorrhages. CONCLUSION: We consider that the risk of hemorrhagic complication is multifactorial but closely related to the chosen technique.
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Authors | Igor Lima Maldonado, Thomas Roujeau, Laura Cif, Victoria Gonzalez, Hassan El-Fertit, Xavier Vasques, Alain Bonafe, Phillippe Coubes |
Journal | Neurosurgery
(Neurosurgery)
Vol. 65
Issue 6 Suppl
Pg. 196-201; discussion 201-2
(Dec 2009)
ISSN: 1524-4040 [Electronic] United States |
PMID | 19934995
(Publication Type: Journal Article)
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Topics |
- Adolescent
- Adult
- Aged
- Brain
(anatomy & histology, physiopathology, surgery)
- Child
- Child, Preschool
- Deep Brain Stimulation
(adverse effects, methods)
- Electrodes, Implanted
(adverse effects, standards)
- Female
- Humans
- Iatrogenic Disease
(prevention & control)
- Intraoperative Complications
(etiology, physiopathology, prevention & control)
- Magnetic Resonance Imaging
(methods)
- Male
- Middle Aged
- Monitoring, Intraoperative
(methods)
- Movement Disorders
(therapy)
- Neural Pathways
(anatomy & histology, physiopathology, surgery)
- Neuronavigation
(methods)
- Postoperative Hemorrhage
(etiology, physiopathology, prevention & control)
- Stereotaxic Techniques
(adverse effects)
- Young Adult
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