Turkish Neurosurgery 2019 , Vol 29 , Num 4
Large Hemorrhagic Cerebral Venous Infarction due to Deep Brain Stimulation Leads Placement. Report of 2 Cases
1Institute of Psychiatry and Neurology, Department of Neurosurgery, Warsaw, Poland
2Academy of Physical Education in Warsaw, Department of Rehabilitation, Poland
3Bródno Regional Hospital, Department of Neurosurgery, Warsaw, Poland
DOI : 10.5137/1019-5149.JTN.22281-17.3 The true incidence of hemorrhagic venous infarctions in deep brain stimulation (DBS) procedures is very difficult to determine. These hemorrhagic venous complications are very rare and often grouped as all hemorrhagic complications. We report the clinical cases of 2 patients with Parkinson’s disease (PD) who received unilateral globus pallidus DBS and developed hemorrhagic venous infarctions. In these 2 patients a small injury to a dural outflow venous structure or a superficial brain vein resulted in hemorrhagic venous infarctions. We present the management of these rare complication with detailed radiologic follow-up. The first patient made a full recovery but the second patient deceased 5 months after DBS surgery due to aspiration pneumonia. We stress that careful planning of a stereotactic trajectory reduces significantly hemorrhagic complications in DBS surgery but not fully exclude some side effects like venous hemorrhagic infarctions which may result in prolong hospitalization or death. Keywords : Hemorrhagic venous infarction, Parkinson’s disease, Pallidal stimulation, Deep brain stimulation, Globus pallidus
Corresponding author : Michał SOBSTYL, mrsob@op.pl