Klassen Bryan T, Rotter Juliana, Crane Colleen, Kaufmann Timothy J, Miller Kai J
Neurology, Mayo Clinic, Rochester, USA.
Neurological Surgery, Mayo Clinic, Rochester, USA.
Cureus. 2022 Jan 23;14(1):e21518. doi: 10.7759/cureus.21518. eCollection 2022 Jan.
Deep brain stimulation (DBS) is a commonly used treatment for medically refractory movement disorders and epilepsy. Intraoperative testing of electrode impedances is routinely done during DBS surgery to identify electrical conduction defects in the system. We present two illustrative cases involving elevated intraoperative impedances. In the first case, the temporal evolution of impedance changes and a postoperative head CT were consistent with a small and slowly resolving air collection along the lead. In the second case, an abnormally high impedance reading was observed at a single electrode and then "transferred" to be observed at an adjacent electrode upon adjustments of the electrode position, likely due to small air collection at a fixed position in the brain tissue. In both cases, careful troubleshooting allowed identification of the issue and avoidance of unnecessary surgical revisions. A thorough understanding of the possible sources of, and troubleshooting for, abnormal impedance readings is needed for effective intraoperative DBS monitoring.
脑深部电刺激术（DBS）是治疗药物难治性运动障碍和癫痫的常用方法。在DBS手术过程中，常规会对电极阻抗进行术中测试，以识别系统中的电传导缺陷。我们展示了两例术中阻抗升高的典型病例。在第一例中，阻抗变化的时间演变及术后头部CT与沿导线的少量且逐渐消散的积气相符。在第二例中，在单个电极处观察到异常高的阻抗读数，在调整电极位置后该读数“转移”至相邻电极，这可能是由于脑组织中固定位置存在少量积气所致。在这两例中，通过仔细排查故障得以识别问题并避免了不必要的手术修正。为了在术中对DBS进行有效监测，需要全面了解异常阻抗读数的可能来源及排查方法。
