Risks of intracranial hemorrhage in deep brain stimulation and ablation in patients With movement disorders
2009
Objective To analyze the risk factors of intracranial hemorrhage in deep brain stimulation(DBS)and ablation procedures in a large series of patients with movement disorders in order to reduce the incidence of hemorrhage.Methads 689 patients treated with DBS and ablation procedures were enrolled in this study(DBS in 113 cases,ablation in 576 cases and DBS after prior unilateral ablation procedure in 11 cases).In 853 target procedures,DBS was employed in 195 targets(188 subthalamic nucleus targets,5 ventral intermediate targets and 2 internal globus pallidus targets),the ablation procedure was employed in 658 targets(478 intemal globus pallidus targets,180 ventral intermediate targets).Results There were 14 asymptomatic and 10 symptomatic intracranial hematomas.There wag a statistically significant relationship between the risk of symptomatic hematoma and hypertension.The incidence of hematoins in 2~4 microelectrode recording penetrations was6.9%.whereas 2.2%in 1 microelectrode recording penetration.There Wag only one agymptomatic hematoma in 195 DBS targets.Conclusion The humber of micreelectrode passes used to determine target location is correlated with the risk of hemorrhage.Ablation procedure carries a higher risk of hemorrhage than that of DBS.
Key words:
Movement disorder; Deep brain stimulation; Pallidotomy; Thalamotomy; Intracerebral hemorrhage
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