A Modified Dura Puncture Procedure to Reduce Brain Shift in Deep Brain Stimulation Surgery: One Institution's Experience

Wu, Yongwei; Xiang, Wei; Wang, Jia-Jing; Liu, Xiaoming; Yi, Dong-Ye; Tian, Han; Zhao, Hongyang; Jiang, Xiaobing; Fu, Peng

doi:10.3389/fneur.2022.845926

Cited by 1 publication

(2 citation statements)

References 25 publications

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“…Microelectrode recording [45][46][47][48][49] Avoidance of sulci 50 Transventricular approaches 45,50,54 Hypertension 50,55,56 Blood thinners [57][58][59][60] Postoperative confusion Risk factor identification [61][62][63][64][65][66][67][68][69] OR time reduction 84,[122][123][124] Lead inaccuracies Cerebrospinal fluid loss [71][72][73][74] Skull-mounted frames [83][84][85][86][87][88][89][90][91][92][93][94] Robotics [95][96][97][98][99]…”

Section: Intracranial Hemorrhagementioning

confidence: 99%

“…73,74 These techniques lead to even further reductions in pneumocephalus (over 75% less), brain shift (over 90% less), and accuracy errors (over 60% less). 73 Regarding the impact of improved modalities on inaccuracy reductions, intraoperative CT and O-arm demonstrated accuracy errors ranging from 0.76 to 1.59 mm, similar to conventional surgeries. [75][76][77][78][79][80] Fiducial-based registration may further enhance O-arm registration.…”

Section: Postoperative Confusionmentioning

confidence: 99%

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Evolution of Deep Brain Stimulation Techniques for Complication Mitigation

Mayer,

Desai,

Aguiar

et al. 2024

Operative Neurosurgery

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Complication mitigation in deep brain stimulation has been a topic matter of much discussion in the literature. In this article, we examine how neurosurgeons as individuals and as a field generated and adapted techniques to prevent infection, lead fracture/lead migration, and suboptimal outcomes in both the acute period and longitudinally. The authors performed a MEDLINE search inclusive of articles from 1987 to June 2023 including human studies written in English. Using the Rayyan platform, two reviewers (J.P. and R.M.) performed a title screen. Of the 776 articles, 252 were selected by title screen and 172 from abstract review for full-text evaluation. Ultimately, 124 publications were evaluated. We describe the initial complications and inefficiencies at the advent of deep brain stimulation and detail changes instituted by surgeons that reduced them. Furthermore, we discuss the trend in both undesired short-term and long-term outcomes with emphasis on how surgeons recognized and modified their practice to provide safer and better procedures. This scoping review adds to the literature as a guide to both new neurosurgeons and seasoned neurosurgeons alike to understand better what innovations have been trialed over time as we embark on novel targets and neuromodulatory technologies.

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