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Published on: July 16, 2014
Delayed complications of deep brain stimulation: 16-year experience in 249 patients
Gustavo Fernández-Pajarín1, A Sesar2, B Ares2
1Department of Neurology, Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain. gferpaj@gmail.com.
Background:
Over the years, most of the deep brain stimulation (DBS) complications described have been mainly related to the surgery itself or the stimulation. Only a few authors have dealt with chronic complications or complications due to implanted material.
Methods:
We retrospectively analyzed complications beyond the 1st month after surgery in 249 patients undergoing DBS at our site for 16 years, with 321 interventions overall.
Results:
Our results show that infection is the most frequent delayed complication (12.5%), the pulse generator being the most common location. Lead breaks (9.3%) are the second most frequent complication. Symptomatic peri-lead edema and cyst formation were exceptional.
Conclusions:
The best knowledge about DBS complications allows for better solutions. In case of infection, conservative treatment or partial removal of the DBS system appears to be safe and reasonable. Intracranial complications related to DBS material such as peri-lead edema and cyst formation have a good prognosis. They may appear long after DBS implantation.
Insights
Infections and lead breaks are the most common long-term complications after deep brain stimulation (DBS). Conservative treatment for infections and good prognoses for material-related issues are highlighted.
Area of Science:
- Neurosurgery
- Neurology
- Biomedical Engineering
Background:
- Deep brain stimulation (DBS) complications are often surgical or stimulation-related.
- Chronic complications and those from implanted materials are less frequently discussed.
Purpose of the Study:
- To analyze delayed complications of deep brain stimulation (DBS) beyond the first month post-surgery.
- To identify the incidence and nature of chronic DBS-related complications.
Main Methods:
- Retrospective analysis of 249 patients undergoing DBS over 16 years.
- Inclusion of 321 interventions with a follow-up period extending beyond the initial postoperative month.
Main Results:
- Infection is the most frequent delayed complication (12.5%), often involving the pulse generator.
- Lead breaks constitute the second most common complication (9.3%).
- Symptomatic peri-lead edema and cyst formation were found to be exceptional.
Conclusions:
- Understanding delayed DBS complications aids in developing better management strategies.
- Conservative infection management or partial system removal is a safe approach.
- Intracranial material complications, like edema and cysts, generally have a good prognosis and can manifest late.
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