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Related Concept Videos

Cerebral Edema l: Introduction01:19

Cerebral Edema l: Introduction

Cerebral edema is a pathological increase in brain water content that disrupts intracranial pressure regulation and impairs neurological function. Because the cranial vault is rigid, even modest increases in tissue volume can compromise cerebral perfusion, distort neural structures, and initiate secondary injury. Cerebral edema develops through four principal mechanisms: vasogenic, cytotoxic, interstitial, and ionic.Vasogenic EdemaVasogenic edema arises from disruption of the blood–brain...
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Cerebral Edema ll: Pathophysiology

Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...

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Perilead Edema in Deep Brain Stimulation: Long-Term Outcomes and Etiologic Correlates.

Luigi G Remore1, Giorgio Fiore2, Elena Pirola2

  • 1Neurosurgery Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.

Neuromodulation : Journal of the International Neuromodulation Society
|October 30, 2025
PubMed
Summary

Perilead edema (PLE) is common after deep brain stimulation (DBS) surgery for Parkinson disease, linked to older age and more microelectrode recording tracks. While not affecting long-term outcomes, it can cause temporary confusion.

Keywords:
Deep brain stimulationParkinson diseaseneuropsychologyperilead edemasurgical complications

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Area of Science:

  • Neurosurgery
  • Neurology
  • Radiology

Background:

  • Deep brain stimulation (DBS) is a key treatment for Parkinson disease (PD) and movement disorders.
  • Perilead edema (PLE) is a known complication of DBS, but its causes and effects are not fully understood.

Purpose of the Study:

  • To investigate the long-term clinical and neuropsychological effects of PLE after DBS.
  • To identify potential etiological factors associated with PLE development.

Main Methods:

  • Retrospective analysis of clinical and neuropsychological data from 51 PD patients post-DBS.
  • MRI assessment of PLE and correlation with clinical variables using statistical analysis.
  • Multivariate regression to determine predictors of edema volume changes.

Main Results:

  • PLE occurred in 68.62% of patients immediately post-DBS.
  • Patients with PLE were older and experienced more postoperative confusion.
  • Increased microelectrode recording (MER) tracks correlated with edema volume and predicted changes.

Conclusions:

  • PLE is a frequent postsurgical complication associated with older age and multiple MER tracks.
  • PLE can transiently increase postoperative confusion but does not impact long-term motor or neuropsychological outcomes.
  • Limiting MER tracks in older patients may help prevent PLE.