Lu Yue, Qiu Chang, Chang Lei, Luo Bei, Dong Wenwen, Zhang Wenbin, Sun Hai-Hua
Department of Functional Neurosurgery, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China.
Department of Neurology, Yancheng Hospital Affiliated Southeast University Medical College, Yancheng, China.
Front Neurol. 2022 May 23;13:886188. doi: 10.3389/fneur.2022.886188. eCollection 2022.
Deep brain stimulation (DBS) has been approved to treat a variety of movement disorders, including Parkinson's disease (PD), essential tremor, and dystonia. Following the DBS surgery, some perioperative and even delayed complications due to intracranial and hardware-related events could occur, which may be life-threatening and require immediate remedial measures.
We report a case of an older woman with advanced PD who developed the unique complication of unilateral cyst formation at the tip of the DBS electrode after undergoing bilateral placement of subthalamic nucleus DBS. After a period of controlled motor symptoms, the patient showed new neurological deficits related to right peri-lead edema. However, the new neurological symptoms regressed quickly over several days with stereotactic implantation of a puncture needle to drain the cyst fluid without removing the affected lead.
The occurrence of an intraparenchymal cyst following DBS surgery is a rare but life-threatening complication that could relate to edema around the electrodes or cerebrospinal fluid tracking. Stereotactic aspiration makes the intracranial cyst regress safely and effectively and ensures that the electrode is in the optimal position of the target nucleus to achieve an effective DBS surgery.
脑深部电刺激术（DBS）已被批准用于治疗多种运动障碍，包括帕金森病（PD）、特发性震颤和肌张力障碍。在DBS手术之后，可能会发生一些因颅内及硬件相关事件导致的围手术期甚至延迟并发症，这些并发症可能危及生命，需要立即采取补救措施。
我们报告一例老年晚期PD女性患者，在接受双侧丘脑底核DBS植入术后，出现了DBS电极尖端单侧囊肿形成这一独特并发症。在一段时间的运动症状得到控制后，患者出现了与右侧电极周围水肿相关的新神经功能缺损。然而，通过立体定向植入穿刺针引流囊液，在未移除受影响电极的情况下，新的神经症状在数天内迅速消退。
DBS手术后脑实质内囊肿的发生是一种罕见但危及生命的并发症，可能与电极周围水肿或脑脊液追踪有关。立体定向抽吸可使颅内囊肿安全有效地消退，并确保电极处于靶核的最佳位置，以实现有效的DBS手术。
