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Optical Measurements during Deep Brain Stimulation Lead Implantation: Safety Aspects.
Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Neurosurgery.
School of Life Sciences FHNW Institute for Medical and Analytical Technologies.
Linköping University, Department of Biomedical Engineering, Division of Biomedical Engineering. Linköping University, Faculty of Science & Engineering. (MINT, CMIV)ORCID iD: 0000-0002-0012-7867
2018 (English)In: Stereotactic and Functional Neurosurgery, ISSN 1011-6125, E-ISSN 1423-0372, Vol. 95, no 6, p. 392-399Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: Intracerebral hemorrhage (ICH) is the most feared complication in deep brain stimulation (DBS) surgery. The aim of the study was to evaluate patient safety and outcome using laser Doppler flowmetry (LDF) as guidance tool during DBS implantations.

METHODS: An LDF probe adapted for the stereotactic system was used as guide for creation of the trajectory. The microcirculation along 83 preplanned trajectories was measured with the guide during DBS surgery for movement disorders. The microvascular blood flow levels were investigated for all measurement positions. Medical record and postoperative radiology were retrospectively reviewed.

RESULTS: Of 2,963 measurement positions, 234 (7.9%) showed at least a doubled blood flow compared to the surrounding tissue. Of these 2.2% had a more than 5 times higher blood flow in front of the probe tip. Along 1 trajectory, a small ICH was detected during surgery. Increased blood flow was more common close to sulci and verticals.

CONCLUSION: Real-time LDF measurement of the microcirculation using a forward-looking probe during DBS surgery can detect blood flow peaks and further minimize the risk of developing ICH. No separate guide tube is necessary as the probe also creates the trajectory for the DBS lead.

Place, publisher, year, edition, pages
2018. Vol. 95, no 6, p. 392-399
Keyword [en]
Deep brain stimulation, Intracerebral hemorrhage, Laser Doppler flowmetry, Safety
National Category
Medical Engineering
Identifiers
URN: urn:nbn:se:liu:diva-144203DOI: 10.1159/000484944PubMedID: 29301132OAI: oai:DiVA.org:liu-144203DiVA: diva2:1172622
Available from: 2018-01-10 Created: 2018-01-10 Last updated: 2018-01-10

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Zsigmond, PeterWårdell, Karin

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Division of Neuro and Inflammation ScienceFaculty of Medicine and Health SciencesDepartment of NeurosurgeryDivision of Biomedical EngineeringFaculty of Science & Engineering
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Stereotactic and Functional Neurosurgery
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