Minimizing pneumocephalus during deep brain stimulation surgery

Area of Science:

• Neurosurgery
• Medical Devices
• Neurology

Background:

• Deep brain stimulation (DBS) is a key treatment for movement disorders.
• Intracranial air introduction during DBS surgery can lead to inaccurate lead placement and reduced treatment efficacy.
• A novel method was developed to mitigate pneumocephalus during DBS procedures.

Purpose of the Study:

• To develop and evaluate a simple technique for reducing pneumocephalus during deep brain stimulation surgery.
• To assess the impact of the technique on targeting accuracy and surgical outcomes.
• To compare pneumocephalus volume between the new technique and standard surgical procedures.

Main Methods:

• A retrospective analysis of 172 DBS lead placements in 89 patients (2014-2022) was conducted.
• Pneumocephalus volume was quantified using CT scans and ITK-SNAP software.
• The technique was compared against standard dural opening methods in awake and asleep DBS surgeries.

Main Results:

• The technique significantly reduced pneumocephalus from 11.2 cm³ to 0.8 cm³ in the first hemisphere (P<0.0001) and 7.6 cm³ to 0.43 cm³ in the second hemisphere (P<0.0001).
• No significant differences in adverse events were observed between the groups.
• The technique group showed lower rates of post-operative headache.

Conclusions:

• A simple and effective technique for reducing pneumocephalus during DBS surgery was developed and validated.
• This method holds promise for improving lead placement accuracy and patient outcomes in DBS procedures.
• The technique offers a safe and beneficial adjunct to standard DBS surgical protocols.