Document Detail


Incidence of hemorrhage associated with electrophysiological studies performed using macroelectrodes and microelectrodes in functional neurosurgery.
MedLine Citation:
PMID:  15926715     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: The goal of this study was to analyze the incidence of intracranial bleeding in patients who underwent procedures guided by microelectrode recording (MER) rather than by macroelectrode stimulation alone.
METHODS: Between March 1994 and July 2001, 178 patients underwent 248 functional neurosurgical procedures performed by the same team at the University of California at Los Angeles. The procedures included pallidotomy (122 patients), thalamotomy (19 patients), and implantation of deep brain stimulation electrodes in the subthalamic nucleus (36 patients), globus pallidus internus (17 patients), and ventralis intermedius nucleus (54 patients). One hundred forty-four procedures involved macroelectrode stimulation and 104 involved MER. Groups were analyzed according to the presence of arterial hypertension, MER or macroelectrode stimulation use, and occurrence of hemorrhage. Nineteen patients with arterial hypertension underwent 28 surgical procedures. Five cases of hemorrhage (2.02%) occurred. One patient presented with hemiparesis and dysphasia but no surgery was required. The incidence of hemorrhage in patients in whom MER was performed was 2.9%, whereas the incidence in patients in whom MER was not used was 1.4% (p = 0.6529). Bleeding occurred in 10.71% of patients with hypertension and 0.91% of those who were nonhypertensive (p = 0.0111). Among the 104 patients in whom MER was performed, 12 had hypertension. Bleeding occurred in two (16.67%) of these 12 patients. An increased incidence of bleeding in hypertensive patients who underwent MER (p = 0.034) was noticed when compared with nonhypertensive patients who underwent MER. A higher number of electrode passes through the parenchyma was observed when MER was used (p = 0.0001). A positive trend between the occurrence of hemorrhage and multiple passes was noticed. Conclusions. Based on the data the authors suggest that a higher incidence of hemorrhage occurs in hypertensive patients, and a higher incidence as well in hypertensive patients who underwent MER rather than macroeletrode stimulation. Special attention should be given to MER use in hypertensive patients and particular attention should be made to multiple passes.
Authors:
Alessandra Gorgulho; Antonio A F De Salles; Leonardo Frighetto; Eric Behnke
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  102     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2005 May 
Date Detail:
Created Date:  2005-06-01     Completed Date:  2005-06-14     Revised Date:  2013-05-20    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  888-96     Citation Subset:  AIM; IM    
Affiliation:
Division of Neurosurgery, University of California at Los Angeles, California, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Cerebral Hemorrhage / etiology*
Child
Child, Preschool
Electric Stimulation / adverse effects,  instrumentation
Electrodes / adverse effects*
Electrophysiology / instrumentation*
Female
Humans
Intracranial Hemorrhage, Hypertensive / etiology
Male
Microelectrodes / adverse effects*
Microsurgery / adverse effects*,  instrumentation
Middle Aged
Retrospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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