Longitudinal Neuropsychological Assessment of Symptomatic Edema after Subthalamic Nucleus Deep Brain Stimulation Surgery: A Case Series Study
Severe non-infectious or non-haemorrhagic brain edema surrounding the electrode represents a rare complication of subthalamic nucleus deep brain stimulation (STN-DBS) surgery. The aim of this study is to report three patients with advanced Parkinson’s Disease (PD) who developed symptomatic brain ede...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-12-01
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| Series: | Neurology International |
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| Online Access: | https://www.mdpi.com/2035-8377/16/1/4 |
| _version_ | 1797297328008200192 |
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| author | Silvia De Ieso Giulia Di Rauso Francesco Cavallieri Daniela Beltrami Alessandro Marti Manuela Napoli Rosario Pascarella Alberto Feletti Valentina Fioravanti Giulia Toschi Vittorio Rispoli Francesca Antonelli Annette Puzzolante Giacomo Pavesi Federico Gasparini Franco Valzania |
| author_facet | Silvia De Ieso Giulia Di Rauso Francesco Cavallieri Daniela Beltrami Alessandro Marti Manuela Napoli Rosario Pascarella Alberto Feletti Valentina Fioravanti Giulia Toschi Vittorio Rispoli Francesca Antonelli Annette Puzzolante Giacomo Pavesi Federico Gasparini Franco Valzania |
| author_sort | Silvia De Ieso |
| collection | DOAJ |
| description | Severe non-infectious or non-haemorrhagic brain edema surrounding the electrode represents a rare complication of subthalamic nucleus deep brain stimulation (STN-DBS) surgery. The aim of this study is to report three patients with advanced Parkinson’s Disease (PD) who developed symptomatic brain edema after STN-DBS surgery treated with intravenous steroids with a specific profile of reversible cognitive alterations. Patients were both assessed with a comprehensive neuropsychological battery including attention, memory, visuo-spatial and executive tasks. They were also briefly assessed for emotional and behavioural alterations, and for possible limitations in the activities of daily living. Normative data for an Italian population were available for all neuropsychological tests. The patients were firstly assessed before the surgery (baseline) as soon as they became symptomatic for the post-surgery edema and a few more times in follow-up up to ten months. In all patients we observed the resolution of cognitive deficits within six months after surgery with the corresponding reabsorption of edema at brain CT scans. The appearance of post-DBS edema is a fairly frequent and clinically benign event. However, in some rare cases it can be very marked and lead to important clinical—albeit transient—disturbances. These events can compromise, at least from a psychological point of view, the delicate path of patients who undergo DBS and can prolong the post-operative hospital stay. In this setting it could be helpful to perform a brain CT scan in 2–3 days with the aim of detecting the early appearance of edema and treating it before it can constitute a relevant clinical problem. |
| first_indexed | 2024-03-07T22:19:06Z |
| format | Article |
| id | doaj.art-544ca21145044db0b159d062a2393ab4 |
| institution | Directory Open Access Journal |
| issn | 2035-8377 |
| language | English |
| last_indexed | 2024-03-07T22:19:06Z |
| publishDate | 2023-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Neurology International |
| spelling | doaj.art-544ca21145044db0b159d062a2393ab42024-02-23T15:29:38ZengMDPI AGNeurology International2035-83772023-12-01161627310.3390/neurolint16010004Longitudinal Neuropsychological Assessment of Symptomatic Edema after Subthalamic Nucleus Deep Brain Stimulation Surgery: A Case Series StudySilvia De Ieso0Giulia Di Rauso1Francesco Cavallieri2Daniela Beltrami3Alessandro Marti4Manuela Napoli5Rosario Pascarella6Alberto Feletti7Valentina Fioravanti8Giulia Toschi9Vittorio Rispoli10Francesca Antonelli11Annette Puzzolante12Giacomo Pavesi13Federico Gasparini14Franco Valzania15Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, ItalyNeurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, ItalyNeurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, ItalyNeurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, ItalyNeurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, ItalyNeuroradiology Unit, Radiology Department, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, ItalyNeuroradiology Unit, Radiology Department, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, ItalyNeurosurgery Unit, Ospedale Civile Baggiovara (OCB) Hospital, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, ItalyNeurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, ItalyNeurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, ItalyNeurology Unit, Neuroscience Head Neck Department, Ospedale Civile Baggiovara (OCB) Hospital, Azienda Ospedaliero-Universitaria di Modena, 41126 Modena, ItalyNeurology Unit, Neuroscience Head Neck Department, Ospedale Civile Baggiovara (OCB) Hospital, Azienda Ospedaliero-Universitaria di Modena, 41126 Modena, ItalyNeurosurgery Unit, Ospedale Civile Baggiovara (OCB) Hospital, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, ItalyNeurosurgery Unit, Ospedale Civile Baggiovara (OCB) Hospital, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, ItalyNeurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, ItalyNeurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, ItalySevere non-infectious or non-haemorrhagic brain edema surrounding the electrode represents a rare complication of subthalamic nucleus deep brain stimulation (STN-DBS) surgery. The aim of this study is to report three patients with advanced Parkinson’s Disease (PD) who developed symptomatic brain edema after STN-DBS surgery treated with intravenous steroids with a specific profile of reversible cognitive alterations. Patients were both assessed with a comprehensive neuropsychological battery including attention, memory, visuo-spatial and executive tasks. They were also briefly assessed for emotional and behavioural alterations, and for possible limitations in the activities of daily living. Normative data for an Italian population were available for all neuropsychological tests. The patients were firstly assessed before the surgery (baseline) as soon as they became symptomatic for the post-surgery edema and a few more times in follow-up up to ten months. In all patients we observed the resolution of cognitive deficits within six months after surgery with the corresponding reabsorption of edema at brain CT scans. The appearance of post-DBS edema is a fairly frequent and clinically benign event. However, in some rare cases it can be very marked and lead to important clinical—albeit transient—disturbances. These events can compromise, at least from a psychological point of view, the delicate path of patients who undergo DBS and can prolong the post-operative hospital stay. In this setting it could be helpful to perform a brain CT scan in 2–3 days with the aim of detecting the early appearance of edema and treating it before it can constitute a relevant clinical problem.https://www.mdpi.com/2035-8377/16/1/4edemadeep brain stimulation DBSneuropsychologicalsubthalamic nucleusSTN-DBS |
| spellingShingle | Silvia De Ieso Giulia Di Rauso Francesco Cavallieri Daniela Beltrami Alessandro Marti Manuela Napoli Rosario Pascarella Alberto Feletti Valentina Fioravanti Giulia Toschi Vittorio Rispoli Francesca Antonelli Annette Puzzolante Giacomo Pavesi Federico Gasparini Franco Valzania Longitudinal Neuropsychological Assessment of Symptomatic Edema after Subthalamic Nucleus Deep Brain Stimulation Surgery: A Case Series Study Neurology International edema deep brain stimulation DBS neuropsychological subthalamic nucleus STN-DBS |
| title | Longitudinal Neuropsychological Assessment of Symptomatic Edema after Subthalamic Nucleus Deep Brain Stimulation Surgery: A Case Series Study |
| title_full | Longitudinal Neuropsychological Assessment of Symptomatic Edema after Subthalamic Nucleus Deep Brain Stimulation Surgery: A Case Series Study |
| title_fullStr | Longitudinal Neuropsychological Assessment of Symptomatic Edema after Subthalamic Nucleus Deep Brain Stimulation Surgery: A Case Series Study |
| title_full_unstemmed | Longitudinal Neuropsychological Assessment of Symptomatic Edema after Subthalamic Nucleus Deep Brain Stimulation Surgery: A Case Series Study |
| title_short | Longitudinal Neuropsychological Assessment of Symptomatic Edema after Subthalamic Nucleus Deep Brain Stimulation Surgery: A Case Series Study |
| title_sort | longitudinal neuropsychological assessment of symptomatic edema after subthalamic nucleus deep brain stimulation surgery a case series study |
| topic | edema deep brain stimulation DBS neuropsychological subthalamic nucleus STN-DBS |
| url | https://www.mdpi.com/2035-8377/16/1/4 |
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