Cerebral peri-lead edema following deep brain stimulation surgery

Prospective Evaluation of the Time Course of White Matter Edema Associated with Implanted Deep Brain Stimulation Electrodes

“…A similar prospective study was done recently in 19 patients, but imag-ing was not obtained at the same time point for each patient, and patients without edema in the first image set did not get a repeat scan [4]. While this white matter edema is often described as a rare occurrence [1,2,7,8,11], Bollerini and colleagues reported edema in 100% (19/19) of patients imaged within 1 month of surgery, and we report the presence of edema following 80% (12/15) of electrode implants from a total of fifteen in this study. In many of the instances of lead edema reported in previous studies, follow-up imaging was not obtained, leaving the true time course of the phenomenon uncertain [1,4,6].…”

“…Often, these patients are asymptomatic, and the edema is an incidental finding [1,[4][5][6]. Most of the reports of this to date have been retrospective series [1,2,[7][8][9] or case reports [10][11][12][13][14]. In these studies, edema was discovered on a CT or MRI after a patient presented with a symptom or following routine postoperative imaging.…”

Cerebrospinal Fluid Leakage to the Chest Subcutaneous Pocket Due to Aggressive Brain Edema around the Leads for Deep Brain Stimulation: A Case Report and Literature Review

“…Symptomatic non-infectious cerebral edema after DBS was confirmed in 91 cases, including the present case (Supplementary Table 1). [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]19,20,23,24) The incidence was reported to be 0.6%-31.6% (per number of operations) 4,10,11,13,16,17) and 1.7%-4.1% (per lead). 6,20) There have been reports of edema, with most studies reporting edema on one side and only a few reporting edema on both sides.…”

“…There are no reports of CSF leakage, as in this case. In the literature, all cases showed improvement upon steroid administration (dexamethasone was used in most cases 4,6,11,13,14,[18][19][20]23) ), or even with routine monitoring without any treatment. 3,5,10,15) Our patient stopped responding to steroid treatment in the second half of the treatment period for an unknown reason.…”

“…Deep brain stimulation (DBS) is an established treatment for Parkinson's disease (PD). 1) However, it has been reported to cause complications, such as bleeding, infection, and hardware-related trouble, 2) and in recent years, there have been reports of non-infectious cerebral edema around the leads; [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] cases of cyst formation around the lead have also been reported. 4,9,11,15,[21][22][23] Here, we report a rare case of sudden cerebral edema after DBS accompanied by cerebrospinal fluid (CSF) leakage to the skin of the chest.…”