Document Detail


Postmortem study of deep brain stimulation of the anterior thalamus: case report.
MedLine Citation:
PMID:  18382294     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: As new clinical applications for deep brain stimulation (DBS) emerge and the number of patients with DBS systems continues to grow, lead technology will also advance. To direct improvement of these leads, improved understanding of the effects of the DBS electrodes and stimulation parameters on the surrounding brain parenchyma is necessary. We present a postmortem evaluation of a patient who had previously undergone bilateral DBS of the anterior thalamic nucleus. CLINICAL PRESENTATION: A 21-year-old, right-handed man with a 2-year history of epilepsy secondary to encephalitis underwent bilateral DBS of the anterior nucleus of the thalamus. He died 8 months after surgery, and his death was classified as a sudden, unexpected, unexplained death as a result of epilepsy. INTERVENTION: Microscopic examination and immunohistochemical analysis using glial fibrillary acidic protein, CD11b, CD45, and CD 68 were performed. The thalami of this patient were then compared with brain tissue obtained from a 45-year-old patient who died as a result of a myocardial infarction and had no history of neurological disease and no surgical intervention. There were no differences in the microscopic and histochemical evaluation of the thalami between patients, other than immediately around the electrode tract. Minimal tissue damage, mild astrocytosis, and mild inflammation surrounding the electrode termination site were observed. CONCLUSION: We report the first postmortem examination after bilateral DBS of the anterior nucleus of the thalamus for epilepsy. A comparison with control tissue showed no significant difference other than mild inflammation along the lead track.
Authors:
Julie G Pilitsis; Yaping Chu; Jeffrey Kordower; Donna C Bergen; Elizabeth J Cochran; Roy A E Bakay
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Neurosurgery     Volume:  62     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-04-02     Completed Date:  2008-06-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E530-2; discussion E532     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois 60612, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anterior Thalamic Nuclei / pathology*
Autopsy
Deep Brain Stimulation / adverse effects*
Epilepsy / therapy*
Humans
Immunohistochemistry
Inflammation / etiology
Male
Microelectrodes / adverse effects

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


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