Large Hemorrhagic Cerebral Venous Infarction due to Deep Brain Stimulation Leads Placement: Report of 2 Cases

Özet

The true incidence of hemorrhagic venous infarctions in deep brain stimulation (DBS) procedures is very difficult to determine.These hemorrhagic venous complications are very rare and often grouped as all hemorrhagic complications. We report the clinicalcases of 2 patients with Parkinson’s disease (PD) who received unilateral globus pallidus DBS and developed hemorrhagic venousinfarctions. In these 2 patients a small injury to a dural outflow venous structure or a superficial brain vein resulted in hemorrhagicvenous infarctions. We present the management of these rare complication with detailed radiologic follow-up. The first patient madea full recovery but the second patient deceased 5 months after DBS surgery due to aspiration pneumonia. We stress that carefulplanning of a stereotactic trajectory reduces significantly hemorrhagic complications in DBS surgery but not fully exclude some sideeffects like venous hemorrhagic infarctions which may result in prolong hospitalization or death.