Electrode displacement after intracerebral hematoma as a complication of a deep brain stimulation procedure

Abstract

Domenico Servello1, Marco Sassi1, Stefano Bastianello2, Guy Umberto Poloni2, Francesca Mancini3, Claudio Pacchetti31Functional Neurosurgery Unit, Istituto di Ricovero e Cura a Carattere Scientifico Galeazzi, Milan, Italy; 2Neuroradiology Unit; 3Parkinson Disease and Movement Disorder Unit, Istituto di Ricovero e Cura a Carattere Scientifico Mondino, Institute of Neurology, Pavia, Italy Objectives: Deep brain stimulation (DBS) is nowadays considered a safe and effective procedure for various movement disorders in which conservative treatments have failed to show significant therapeutic results. One of the most common complications of definitive electrode positioning is intraparenchymal hemorrhage.Materials and methods: Authors report the case of a 55-year-old female patient treated for Parkinson’s disease in which intraparenchymal hemorrhage developed after DBS procedure, leading to significant (about 8 mm at the neuroradiological controls) displacement of an otherwise correctly positioned DBS electrode.Results: After conservative management, the hematoma spontaneously resolved. Late neuroradiological controls documented correct, symmetrically positioned electrodes, comparable to the immediate postoperative controls.Conclusions: Six months follow-up endpoint results of the DBS treatment were considered satisfying by an independent neurologist, with modest residual neurological deficits, demonstrating that re-positioning of the electrode was unnecessary in this rare complication.Keywords: deep brain stimulation, electrodes, outcomes, implant, case report