Are Transventricular Approaches Associated With Increased Hemorrhage? A Comparative Study in a Series of 624 Deep Brain Stimulation Surgeries
Runge J, Nagel JM, Ascencao LC, Blahak C, Kinfe TM, Schrader C, Wolf ME, Saryyeva A, Krauss JK (2022)
Publication Type: Journal article
Publication year: 2022
Journal
Book Volume: 23
Pages Range: E108-E113
Journal Issue: 2
DOI: 10.1227/ons.0000000000000275
Abstract
BACKGROUND:Deep brain stimulation (DBS) surgery has advanced tremendously, for both clinical applications and technology. Although DBS surgery is an overall safe procedure, rare side effects, in particular, hemorrhage, may result in devastating consequences. Although there are certain advantages with transventricular trajectories, it has been reasoned that avoidance of such trajectories would likely reduce hemorrhage.OBJECTIVE:To investigate the possible impact of a transventricular trajectory as compared with a transcerebral approach on the occurrence of symptomatic and asymptomatic hemorrhage after DBS electrode placement.METHODS:Retrospective evaluation of 624 DBS surgeries in 582 patients, who underwent DBS surgery for movement disorders, chronic pain, or psychiatric disorders. A stereotactic guiding cannula was routinely used for DBS electrode insertion. All patients had postoperative computed tomography scans within 24 hours after surgery.RESULTS:Transventricular transgression was identified in 404/624 DBS surgeries. The frequency of hemorrhage was slightly higher in transventricular than in transcerebral DBS surgeries (15/404, 3.7% vs 6/220, 2.7%). While 7/15 patients in the transventricular DBS surgery group had a hemorrhage located in the ventricle, 6 had an intracerebral hemorrhage along the electrode trajectory unrelated to transgression of the ventricle and 2 had a subdural hematoma. Among the 7 patients with a hemorrhage located in the ventricle, only one became symptomatic. Overall, a total of 7/404 patients in the transventricular DBS surgery group had a symptomatic hemorrhage, whereas the hemorrhage remained asymptomatic in all 6/220 patients in the transcerebral DBS surgery group.CONCLUSION:Transventricular approaches in DBS surgery can be performed safely, in general, when special precautions such as using a guiding cannula are routinely applied.
Authors with CRIS profile
Thomas Mehari Kinfe
Professur für Neurochirurgie mit dem Schwerpunkt Funktionelle Stereotaktische Neurochirurgie
Involved external institutions
Medizinische Hochschule Hannover (MHH) / Hannover Medical School
Germany (DE)
Katharinenhospital Stuttgart
Germany (DE)
Ortenau Klinikum
Germany (DE)
Germany (DE)
Katharinenhospital Stuttgart
Germany (DE)
Ortenau Klinikum
Germany (DE)
How to cite
APA:
Runge, J., Nagel, J.M., Ascencao, L.C., Blahak, C., Kinfe, T.M., Schrader, C.,... Krauss, J.K. (2022). Are Transventricular Approaches Associated With Increased Hemorrhage? A Comparative Study in a Series of 624 Deep Brain Stimulation Surgeries. Operative Neurosurgery, 23(2), E108-E113. https://doi.org/10.1227/ons.0000000000000275
MLA:
Runge, Joachim, et al. "Are Transventricular Approaches Associated With Increased Hemorrhage? A Comparative Study in a Series of 624 Deep Brain Stimulation Surgeries." Operative Neurosurgery 23.2 (2022): E108-E113.
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