Magnant Gabrielle A, Darbin Olivier, McKee Kelsey, Martino Anthony
Department of Neurosurgery, University South Alabama, Mobile, Alabama.
Department of Plastic Surgery, University South Alabama, Mobile, Alabama.
J Neurosurg Case Lessons. 2025 May 5;9(18). doi: 10.3171/CASE24833.
Scalp complications following deep brain stimulation (DBS) procedures can lead to hardware removal, posing significant clinical and economic challenges. This report describes 3 cases managed with adjacent tissue rearrangement flap and full-thickness skin graft procedures, along with antibiotic therapy.
Among the 3 cases, 2 patients presented with local infections on initial evaluation. Six months postreconstruction, scalp complications had resolved in 2 patients without interruption to neuromodulation therapy. Of these 2 patients, one had an active infection at the initial presentation.
Contrary to the prevailing assumption that DBS hardware should be removed in the presence of scalp complications associated with active infection, the authors' findings suggest that hardware can sometimes be preserved. With comprehensive management, including empirical antibiotic therapy, the authors observed that alternative approaches to hardware removal could be valuable for patients at risk of losing DBS therapeutic benefits. https://thejns.org/doi/10.3171/CASE24833.
脑深部电刺激（DBS）手术后的头皮并发症可导致硬件移除，带来重大的临床和经济挑战。本报告描述了3例采用邻近组织重排皮瓣和全厚皮肤移植手术以及抗生素治疗的病例。
在这3例病例中，2例患者在初次评估时出现局部感染。重建术后6个月，2例患者的头皮并发症得到解决，神经调节治疗未中断。在这2例患者中，1例在初次就诊时存在活动性感染。
与普遍认为在存在与活动性感染相关的头皮并发症时应移除DBS硬件的假设相反，作者的研究结果表明，硬件有时可以保留。通过包括经验性抗生素治疗在内的综合管理，作者观察到，对于有失去DBS治疗益处风险的患者，替代硬件移除的方法可能很有价值。https://thejns.org/doi/10.3171/CASE24833 。
