Ramirez-Zamora Adolfo, Levine David, Sommer David B, Dalfino John, Novak Peter, Pilitsis Julie G
Department of Neurology, Albany Medical College, Albany, N.Y., USA.
Stereotact Funct Neurosurg. 2013;91(5):338-41. doi: 10.1159/000350021. Epub 2013 Aug 27.
Following deep brain stimulation (DBS) surgery, a variety of potential mechanical or functional complications ranging from perioperative events to hardware malfunction may occur. We present 2 patients who developed a unique complication of cyst formation at the tip of the DBS electrode in the absence of infection. One patient had a unilateral ventral intermediate lead placement for essential tremor, and the other had bilateral subthalamic nucleus (STN) placement for Parkinson's disease. After a period of symptom control, at 3 and 8 months after surgery, respectively, both patients developed new neurological deficits and were found to have a cyst at the left DBS lead tip. The right lead in the patient with the bilateral STN implant was without issue. Both affected leads were removed and the problematic symptoms regressed quickly over several days, though the lesion effect on the patients' initial tremor symptoms lasted for months. Bacteriological cultures of the removed electrodes and wounds were negative. We report a rare complication of DBS and show that simply removing the involved lead results in cyst resolution.
在脑深部电刺激（DBS）手术后，可能会出现各种潜在的机械性或功能性并发症，从围手术期事件到硬件故障不等。我们报告2例患者，在无感染的情况下，DBS电极尖端出现了独特的囊肿形成并发症。1例患者因特发性震颤进行了单侧腹中间核电极植入，另1例患者因帕金森病进行了双侧丘脑底核（STN）植入。在一段时间的症状控制后，分别在术后3个月和8个月，2例患者均出现了新的神经功能缺损，且发现左侧DBS电极尖端有囊肿。双侧STN植入患者的右侧电极未出现问题。2根受累电极均被移除，有问题的症状在几天内迅速消退，尽管病变对患者最初震颤症状的影响持续了数月。移除电极和伤口的细菌培养结果均为阴性。我们报告了一种罕见的DBS并发症，并表明简单地移除受累电极可使囊肿消退。
