Subacute Subdural Hematoma in a Patient with Bilateral DBS Electrodes

Case Reports in Neurological Medicine
Ha Son Nguyen, Peter A Pahapill

Abstract

Subdural hematomas (SDH) in patients with implanted deep brain stimulating (DBS) electrodes are rare. Only a handful of cases have been reported in the literature. No clear management guidelines exist regarding the management of the hematoma and the existing electrodes. We describe a 68-year-old female with bilateral DBS electrodes, who presented with acute, severe hemiparesis due to a large subacute SDH with associated electrode displacement. Urgent hematoma evacuation reversed the hemiparesis; the electrodes were left undisturbed. Brain reexpansion occurred promptly. The patient was able to benefit from stable DBS therapies within 3 weeks of hematoma evacuation, maintained at 1.5-year follow-up. The case highlights that despite relative electrode migration due to a subdural hematoma, the electrodes may not require revision during initial hematoma evacuation or in a delayed fashion. Timely hematoma evacuation, coupled with brain reexpansion, may be adequate for the electrode to travel back to its original position and effect reasonable DBS therapies.

References

Oct 16, 2002·Stereotactic and Functional Neurosurgery·A BericB Kopell
Apr 15, 2003·Journal of Neurosurgery·Atsushi UmemuraGordon H Baltuch
Oct 14, 2011·Neuromodulation : Journal of the International Neuromodulation Society·Young Seok ParkJin Woo Chang
Nov 30, 2011·Neurologia Medico-chirurgica·Atsushi UmemuraKazuo Yamada

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Citations

May 13, 2017·Current Neurology and Neuroscience Reports·Giovanni Cossu, Mariachiara Sensi

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