Abstract
In deep brain stimulation (DBS) surgery, after intracranial lead implantation, lead caps are tunneled into the subgaleal space for later connection to internal pulse generator (IPG) extension wires. In the subsequent IPG implantation procedure, the lead cap must be localized by palpation in order to plan an incision in the scalp to complete this connection. However, if the IPG implantation is done the same day as the intracranial lead implantation, palpation of the lead cap may be challenging in a thick or postoperatively edematous scalp. Manufacturers suggest using fluoroscopy in these instances, but fluoroscopy provides poor soft tissue visualization, requires further unnecessary radiation exposure to both the patient and the surgical team, and can be cumbersome. Portable ultrasound (US) machines are readily available in many operating rooms, and can be used to easily and accurately localize the lead cap prior to IPG implantation.
Key words
deep brain stimulation - fluoroscopy - ultrasound
References
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1
Pena E, Pastor J, Hernando V. et al .
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Sherif C, Dorfer C, Kalteis K. et al .
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Lead Kit for Deep Brain Stimulation Implant Manual.. Minneapolis, MN: Medtronic, Inc; 2008
Correspondence
P. S. LarsonMD
Department of Neurological
Surgery
University of California San
Francisco
505 Parnassus Avenue
Box 0112
San Francisco
California 94143-0112
USA
Phone: +1/415/353 3489
Fax: + 1/415/353 3459
Email: LarsonP@neurosurg.ucsf.edu
