Abstract | BACKGROUND AND PURPOSE: The aim of this study was to define the prevalence and characteristics of peri- electrode edema in a prospective cohort of patients undergoing deep brain stimulation (DBS) surgery and to correlate it with clinical findings. METHODS: We performed brain magnetic resonance imaging (MRI) between 7 and 20 days after surgery in 19 consecutive patients undergoing DBS surgery for Parkinson's disease. The T2-weighted hyperintensity surrounding DBS leads was characterized and quantified. Any evidence of bleeding around the leads was also evaluated. Clinical and follow-up data were recorded. In a subgroup of patients, a follow-up MRI was performed 3-6 weeks after surgery. We also retrospectively reviewed the post-operative computed tomography scans of patients who underwent DBS at our center since 2013. RESULTS: Magnetic resonance imaging showed a peri-lead edematous reaction in all (100%) patients, which was unilateral in three patients (15.8%). In six patients (31.6%), we detected minor peri-lead hemorrhage. Edema completely resolved in eight out of 11 patients with a follow-up MRI and was markedly reduced in the others. Most patients were asymptomatic but six (31.6%) manifested various degrees of confusional state without motor symptoms. We found no significant correlation between edema volume, distribution and any clinical feature, including new post-operative neurological symptoms. The retrospective computed tomography analysis showed that peri- electrode hypodensity consistent with edema is absent at early post-operative imaging but is common at scans performed >3 days after surgery. CONCLUSIONS: Peri- electrode edema is a common, transient reaction to DBS lead placement and a convincing relation between edema and post-operative clinical status is lacking.
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Authors | L Borellini, G Ardolino, G Carrabba, M Locatelli, P Rampini, S Sbaraini, E Scola, S Avignone, F Triulzi, S Barbieri, F Cogiamanian |
Journal | European journal of neurology
(Eur J Neurol)
Vol. 26
Issue 3
Pg. 533-539
(03 2019)
ISSN: 1468-1331 [Electronic] England |
PMID | 30358915
(Publication Type: Journal Article)
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Copyright | © 2018 EAN. |
Topics |
- Aged
- Brain Edema
(diagnostic imaging, etiology)
- Deep Brain Stimulation
(adverse effects)
- Electrodes, Implanted
(adverse effects)
- Female
- Follow-Up Studies
- Humans
- Magnetic Resonance Imaging
(methods)
- Male
- Middle Aged
- Parkinson Disease
(therapy)
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