Stereotactic surgery represents a highly effective therapy for the treatment of Parkinson's
disease and other movement disorders refractory to medical treatment. Despite its
demonstrated safety, some rare adverse events could result in potentially disabling
outcomes. Among them, hemorrhagic complications (HC) are unarguably the most dangerous
and dreaded. In a recent systematic survey of the literature, the most important patient-related
factors associated with an increased risk of HC were age and hypertension, whereas
risk factors related to surgical technique included the use of intraoperative microelectrode
recording (MER), the number of MER penetrations, and the sulcal or ventricular involvement
by the trajectory [
[1]
]. The incidence of HC in studies adopting MER was significantly higher than that reported
with exclusively image-guided approaches [
1
,
2
,
3
]. Furthermore, the coexistence of hypertension and MER has been associated to an additional
rise of bleeding incidence [
[4]
].To read this article in full you will need to make a payment
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References
- Reducing hemorrhagic complications in functional neurosurgery: a large case series and systematic literature review.J Neurosurg. 2012; 116: 84-94
- Risks of common complications in deep brain stimulation surgery: management and avoidance.J Neurosurg. 2014; 120: 132-139
- Risks of intracranial hemorrhage in patients with Parkinson's disease receiving deep brain stimulation and ablation.Parkinsonism Relat Disord. 2010; 16: 96-100
- Incidence of hemorrhage associated with electrophysiological studies performed using macroelectrodes and microelectrodes in functional neurosurgery.J Neurosurg. 2005; 102: 888-896
- Deep brain stimulation of the subthalamic nucleus: anatomical, neurophysiological, and outcome correlations with the effects of stimulation.J Neurol Neurosurg Psychiatry. 2002; 72: 53-58
- Atlas for stereotaxy of the human brain.Thieme Publishers, Stuttgart, New York1977
Article info
Publication history
Published online: July 26, 2014
Accepted:
July 22,
2014
Received:
July 12,
2014
Footnotes
Financial disclosures and conflict of interest: Dr. Maurizio Zibetti and Prof. Michele Lanotte received travel grants for attending scientific congresses from Medtronic. Prof. Lopiano Leonardo has received honoraria for lecturing from Medtronic. Dr. Alberto Romagnolo and Dr. Mario Giorgio Rizzone declare no conflict of interests.
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
