脑深部电刺激的延迟并发症：249例患者的16年经验
Delayed complications of deep brain stimulation: 16-year experience in 249 patients.
作者信息
Fernández-Pajarín Gustavo, Sesar A, Ares B, Relova J L, Arán E, Gelabert-González M, Castro A
机构信息
Department of Neurology, Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain.
Department of Neurophysiology, Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain.
出版信息
Acta Neurochir (Wien). 2017 Sep;159(9):1713-1719. doi: 10.1007/s00701-017-3252-7. Epub 2017 Jun 24.
BACKGROUND
Over the years, most of the deep brain stimulation (DBS) complications described have been mainly related to the surgery itself or the stimulation. Only a few authors have dealt with chronic complications or complications due to implanted material.
METHODS
We retrospectively analyzed complications beyond the 1st month after surgery in 249 patients undergoing DBS at our site for 16 years, with 321 interventions overall.
RESULTS
Our results show that infection is the most frequent delayed complication (12.5%), the pulse generator being the most common location. Lead breaks (9.3%) are the second most frequent complication. Symptomatic peri-lead edema and cyst formation were exceptional.
CONCLUSIONS
The best knowledge about DBS complications allows for better solutions. In case of infection, conservative treatment or partial removal of the DBS system appears to be safe and reasonable. Intracranial complications related to DBS material such as peri-lead edema and cyst formation have a good prognosis. They may appear long after DBS implantation.
背景
多年来，所描述的大多数脑深部电刺激（DBS）并发症主要与手术本身或刺激有关。只有少数作者探讨过慢性并发症或植入材料引起的并发症。
方法
我们回顾性分析了在我们机构接受16年DBS治疗的249例患者术后1个月后的并发症，总共进行了321次干预。
结果
我们的结果表明，感染是最常见的延迟并发症（12.5%），脉冲发生器是最常见的感染部位。导线断裂（9.3%）是第二常见的并发症。有症状的导线周围水肿和囊肿形成较为罕见。
结论
对DBS并发症的深入了解有助于找到更好的解决方案。发生感染时，保守治疗或部分移除DBS系统似乎是安全合理的。与DBS材料相关的颅内并发症，如导线周围水肿和囊肿形成，预后良好。它们可能在DBS植入后很长时间才出现。
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