Our Summary

Deep brain stimulation (DBS) is a surgical procedure used to help manage symptoms of Parkinson’s disease, but one common issue is pneumocephalus, which is the presence of air in the skull. This can cause problems, including making the electrodes less accurate, complicating assessments after surgery, and negatively affecting the overall results of the surgery. This study looked back at 138 patients with Parkinson’s disease who had DBS surgery and compared the results of the original surgical technique to a new procedure. This new procedure includes changes like modifying the patient’s position during surgery, puncturing the dura (the outermost layer of the brain and spinal cord), and sealing with a liquid. The new procedure greatly reduced the amount of air in the skull after surgery, with almost 93% of patients showing no visible air or less than 1 mL. The new procedure also led to less movement of the electrode tips after surgery. This research suggests that the new procedure effectively reduces pneumocephalus and makes the electrodes used in DBS surgery more stable after the operation.

FAQs

  1. What is pneumocephalus and how does it affect deep brain stimulation surgery?
  2. How does the new surgical procedure for deep brain stimulation reduce pneumocephalus?
  3. What are the benefits of the new surgical procedure for deep brain stimulation compared to the original technique?

Doctor’s Tip

A helpful tip a doctor might tell a patient about brain surgery is to follow post-operative care instructions carefully, including avoiding activities that could potentially dislodge or move the electrodes. It’s important to attend all follow-up appointments and communicate any concerns or changes in symptoms to your healthcare team. Additionally, staying informed about advancements in surgical techniques, like the modified procedure mentioned in this study, can help improve the overall success and outcomes of the surgery.

Suitable For

Patients with Parkinson’s disease who have not responded well to medication or other non-invasive treatments are typically recommended for deep brain stimulation (DBS) surgery. Other patients who may be recommended for brain surgery include those with:

  1. Brain tumors
  2. Epilepsy that is not well controlled with medication
  3. Aneurysms or arteriovenous malformations (AVMs)
  4. Traumatic brain injuries
  5. Chronic pain conditions
  6. Movement disorders such as essential tremor or dystonia

It is important for patients to undergo a thorough evaluation by a neurosurgeon and other specialists to determine if they are good candidates for brain surgery. The risks and benefits of surgery should be carefully considered before proceeding with any surgical intervention.

Timeline

Before brain surgery:

  1. Patient is diagnosed with Parkinson’s disease and explores treatment options.
  2. Patient and medical team decide that deep brain stimulation (DBS) surgery is the best option.
  3. Patient undergoes pre-operative testing and evaluations to ensure they are a good candidate for surgery.
  4. Patient discusses risks and benefits of the surgery with their medical team.
  5. Surgery date is scheduled and patient prepares for the procedure.

After brain surgery:

  1. Patient undergoes DBS surgery, where electrodes are implanted in the brain.
  2. Patient is monitored closely in the hospital for any complications or side effects.
  3. Patient may experience temporary side effects such as headaches, dizziness, or changes in mood.
  4. Patient is discharged from the hospital and begins the recovery process at home.
  5. Patient continues to follow up with their medical team for adjustments to the DBS device and ongoing care.
  6. Patient may experience improvements in their symptoms over time as the DBS therapy takes effect.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with DBS surgery, including pneumocephalus?

  2. How will the surgical technique used in my DBS procedure affect the presence of air in my skull and the stability of the electrodes?

  3. What steps will be taken during the surgery to minimize the risk of pneumocephalus and ensure the best possible outcome?

  4. How will the presence of air in my skull after surgery impact the effectiveness of the DBS treatment for my Parkinson’s disease symptoms?

  5. Are there any alternative surgical techniques or approaches that could further reduce the risk of pneumocephalus and improve the overall results of the surgery?

  6. What is the success rate of the new procedure compared to the original technique in terms of reducing pneumocephalus and electrode stability?

  7. How long is the recovery process expected to be following DBS surgery, and how will the presence of air in my skull impact this recovery period?

  8. What post-operative care and monitoring will be required to ensure the best possible outcome after DBS surgery, especially in relation to pneumocephalus?

Reference

Authors: Wang R, Liu K, Yu F, Guo L, Ma J, Chai Y, Zhang X, Zhou H. Journal: Oper Neurosurg. 2025 Jan 6;29(2):219-229. doi: 10.1227/ons.0000000000001460. PMID: 39760493