Asleep Deep Brain Stimulation Reduces Incidence of Intracranial Air during Electrode Implantation

Stereotactic and Functional Neurosurgery
Andrew L KoKim J Burchiel

Abstract

Asleep deep brain stimulation (aDBS) implantation replaces microelectrode recording for image-guided implantation, shortening the operative time and reducing cerebrospinal fluid egress. This may decrease pneumocephalus, thus decreasing brain shift during implantation. To compare the incidence and volume of pneumocephalus during awake (wkDBS) and aDBS procedures. A retrospective review of bilateral DBS cases performed at Oregon Health & Science University from 2009 to 2017 was undertaken. Postimplantation imaging was reviewed to determine the presence and volume of intracranial air and measure cortical brain shift. Among 371 patients, pneumocephalus was noted in 66% of wkDBS and 15.6% of aDBS. The average volume of air was significantly higher in wkDBS than aDBS (8.0 vs. 1.8 mL). Volumes of air greater than 7 mL, which have previously been linked to brain shift, occurred significantly more frequently in wkDBS than aDBS (34 vs 5.6%). wkDBS resulted in significantly larger cortical brain shifts (5.8 vs. 1.2 mm). We show that aDBS reduces the incidence of intracranial air, larger air volumes, and cortical brain shift. Large volumes of intracranial air have been correlated to shifting of brain structures during DBS procedures, a...Continue Reading

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Citations

Jan 11, 2019·Neuromodulation : Journal of the International Neuromodulation Society·Naomi I KremerJ Marc C van Dijk
Jan 4, 2020·Neurosurgical Review·Giacomo BeggioMassimo Piacentino
Dec 13, 2019·Neuromodulation : Journal of the International Neuromodulation Society·Jun WangShao-Wu Ou
Feb 6, 2020·Stereotactic and Functional Neurosurgery·Luigi AlbanoNader Pouratian
Feb 23, 2020·Stereotactic and Functional Neurosurgery·Peter Zsigmond, Karin Wårdell

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