Sobstyl Michał, Brzuszkiewicz-Kuźmicka Grażyna, Aleksandrowicz Marta, Pasterski Tomasz
Institute of Psychiatry and Neurology, Department of Neurosurgery, Warsaw, Poland.
Turk Neurosurg. 2019;29(4):611-614. 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.
在脑深部电刺激（DBS）手术中，出血性静脉梗死的真实发生率很难确定。这些出血性静脉并发症非常罕见，通常被归为所有出血性并发症。我们报告了2例帕金森病（PD）患者的临床病例，他们接受了单侧苍白球DBS手术，并发生了出血性静脉梗死。在这2例患者中，硬脑膜流出静脉结构或浅表脑静脉的轻微损伤导致了出血性静脉梗死。我们介绍了对这些罕见并发症的处理及详细的影像学随访情况。第一例患者完全康复，但第二例患者在DBS手术后5个月因吸入性肺炎死亡。我们强调，立体定向轨迹的精心规划可显著降低DBS手术中的出血性并发症，但不能完全排除诸如静脉出血性梗死等一些副作用，这些副作用可能导致住院时间延长或死亡。
