Intracerebral haematomas after deep brain stimulation surgery in a patient with Tourette syndrome and low factor XIIIA activity

Idris, Zamzuri; Ghani, Abdul Rahman Izani; Mar, Winn; Bhaskar, Shalini; Hassan, Wan Mohd Nazaruddin Wan; Tharakan, John; Abdullah, Jafri Malin; Omar, Julia; Abass, Saruddin; Hussin, Suryati; Abdullah, Wan Zaidah

doi:10.1016/j.jocn.2010.01.054

Cited by 36 publications

(27 citation statements)

References 3 publications

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“…[95] Stimulation of this area aimed at reducing the overactivity of the thalamocortical system that resulted from an apparent deficient inhibitory gamma-aminobutyric acid (GABA)-mediated basal ganglia influence. [88] Several target areas within the thalamus have been reported since 1999: The nucleus ventro-oralis internus–centromedian nucleus–parafascicularis complex,[543445883] the centromedian–parafascicular nuclei,[425180103] and the dorsomedial thalamus. [98] The first pallidal DBS study for GTS[94] reported on posteroventral (motor) GPi implantation (with concomitant thalamic implantation).…”

Section: Resultsmentioning

confidence: 99%

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Deep brain stimulation of the globus pallidus internus and Gilles de la Tourette syndrome: Toward multiple networks modulation

Saleh¹,

Gonzalez-Martinez²,

Cif³

et al. 2012

Surg Neurol Int

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Background:Gilles de la Tourette's syndrome (GTS) is a complex neuropsychiatric disorder characterized by disabling motor and vocal tics. The pathophysiology of GTS remains poorly understood. Conventional treatment consists in pharmacological and behavioral treatment. For patients suffering severe adverse effects or not responding to pharmacological treatment, deep brain stimulation (DBS) presents an alternative treatment. However, the optimal target choice in DBS for GTS remains a divisive issue.Methods:A PubMed search from 1999 to 2012 was conducted. Thirty-three research articles reporting on DBS in patients with GTS were selected and analyzed.Results:Eighty-eight patients with Tourette's syndrome were treated since 1999 with DBS. The majority of patients received thalamic stimulation. Significantly fewer patients were treated with globus pallidus internus stimulation. Occasionally, the anterior limb of the internal capsule and the nucleus accumbens were implanted. The subthalamic nucleus was selected once. All targets were reported with positive results, but of variable extent. Only 14 patients exhibited level 1 evidence.Conclusion:In light of the wide spectrum of associated behavioral co-morbidities in GTS, multiple networks modulation may result in the most efficacious treatment strategy. The optimal locations for DBS within the cortico-basal ganglia-thalamocortical circuits remain to be established. However, at the current stage, comparison between targets should be done with great caution. Significant disparity between number of patients treated per target, methodological variability, and quality of reporting renders a meaningful comparison between targets difficult. Randomized controlled trials with larger cohorts and standardization of procedures are urgently needed.

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Section: Resultsmentioning

confidence: 99%

“…[25434451587680839598101] Forty-three patients were operated (37 males, 6 females). Sample sizes varied from case reports ( n = 10), on 1–6 subjects,[254344515876809598101] to prospective cohort studies with 18 subjects. [83] Mean sample size was six subjects per study (SD = 5).…”

Section: Resultsmentioning

confidence: 99%

Deep brain stimulation of the globus pallidus internus and Gilles de la Tourette syndrome: Toward multiple networks modulation

Saleh¹,

Gonzalez-Martinez²,

Cif³

et al. 2012

Surg Neurol Int

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“…We had one patient with Tourette's syndrome who developed a spontaneous intracranial haemorrhage shortly following DBS (8). Clinically, this patient complained of headaches with no new neurological deficit.…”

Section: Surgical Complicationsmentioning

confidence: 99%

Deep Brain Stimulation (DBS) for Movement Disorders: An Experience in Hospital Universiti Sains Malaysia (HUSM) Involving 12 Patients

et al. 2017

MJMS

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Deep brain stimulation (DBS) was first introduced in 1987 to the developed world. As a developing country Malaysia begun its movement disorder program by doing ablation therapy using the Radionics system. Hospital Universiti Sains Malaysia a rural based teaching hospital had to take into consideration both health economics and outcomes in the area that it was providing neurosurgical care for when it initiated its Deep Brain Stimulation program. Most of the patients were from the low to medium social economic groups and could not afford payment for a DBS implant. We concentrated our DBS services to Parkinson's disease, Tourette's Syndrome and dystonia patients who had exhausted medical therapy. The case series of these patients and their follow-up are presented in this brief communication.

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“…30 Electrode implantation can cause intracerebral haemorrhage. 31 Thus, electrode implantation in the left hemisphere is more likely to be associated with a higher proportion of language complications than implantation in the right hemisphere. Given these pathophysiological, anatomical and clinical considerations, electrodes were implanted into the right GPi as the target for DBS in the present cases, as this may be less likely to cause functional damage and complications than implantation into the 33 Observations in the present cases are, therefore, clinically relevant and suggest that unilateral DBS of the right GPi is effective for some patients with Tourette's syndrome.…”

Section: Unilateral Gpi Dbs In Tsmentioning

confidence: 99%

Unilateral Deep Brain Stimulation of the Right Globus Pallidus Internus in Patients with Tourette's Syndrome: Two Cases with Outcomes After 1 Year and a Brief Review of the Literature

Dong

Zhuang

et al. 2012

J Int Med Res

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Tourette's syndrome is a complex neuropsychiatric disorder, characterized by tics. Bilateral globus pallidus internus (GPi) deep brain stimulation (DBS) has been considered to be an effective treatment for refractory Tourette's syndrome. Postoperative outcomes are described after 12 months' follow-up in a 41-year-old male patient and a 22-year-old male patient with Tourette's syndrome, both of whom underwent unilateral electrode implantations into the right GPi for DBS. These patients were diagnosed with Tourette's syndrome in childhood and, despite long-term therapy with a range of antipsychotic medications, continued to experience disabling tics in adulthood. Improvements in tic severity of 58.5% and 53.1% were observed at 12 months in the older and younger patient, respectively; improvements were determined by the Yale Global Tic Severity Scale. Both patients also experienced reductions in tic frequency and reported improvements in their health-related quality of life. Improvements in tics were similar to previous reports involving patients who underwent bilateral GPi DBS. These cases suggest that unilateral DBS of the right GPi is effective and might be a viable surgical choice for some patients with Tourette's syndrome.

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Intracerebral haematomas after deep brain stimulation surgery in a patient with Tourette syndrome and low factor XIIIA activity

Cited by 36 publications

References 3 publications

Deep brain stimulation of the globus pallidus internus and Gilles de la Tourette syndrome: Toward multiple networks modulation

Deep brain stimulation of the globus pallidus internus and Gilles de la Tourette syndrome: Toward multiple networks modulation

Deep Brain Stimulation (DBS) for Movement Disorders: An Experience in Hospital Universiti Sains Malaysia (HUSM) Involving 12 Patients

Unilateral Deep Brain Stimulation of the Right Globus Pallidus Internus in Patients with Tourette's Syndrome: Two Cases with Outcomes After 1 Year and a Brief Review of the Literature

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