Risks of Surgery

What are the risks of this procedure?

• The major risk is that of hemorrhage. The risk of brain hemorrhage, (i.e. bleeding in the surgical site), is less than 2%. Routine pre-operative blood tests will be performed to determine whether you are at increased risk of bleeding. If a hemorrhage is identified, it may require only observation, or in rare instances, surigcal evacuation. You may be completely asymptomatic from the hemorrhage, or in rare instances hemorrhage may result in death, coma, or significant permanent disability (e.g. paralysis). Thalamic procedures on the left side of the brain (the most common side treated since most patients are right-handed) may result in slurred speech.
• Any time hardware is implanted into the human body there is a risk of it becoming infected. This is a rare occurrence; however, if it does occur, the device must be removed, even if it is working. You will be given antibiotics during the testing phase and for 48 hours after implantation to reduce the risk of infection.
• Risk of neurological complication (ie. stroke). Implantation may cause damage to critical structures of the brain causing weakness or paralysis, inability to speak. These complications are very rare and are minimized by the use of the stereotactic frame, computer guidance system, and microelectrode recording. If neurologic complications are related to stimulation and cannot be corrected by altering the stimulation settings, the stimulator will be shut off and the electrode removed at the second operation.
• Patients may note painful sensations when the stimulator is first turned on. Typically, this lasts only a few seconds. If these painful sensations last longer, then the device may have to be reprogrammed.
• Risk of general anesthesia. These risks include severe allergic reactions to medications, and airway difficulties leading to stroke, heart attack, or death. These occurrences are rare (< 1%) and will be minimized by a complete medical evaluation prior to surgery.
• Reversible side effects: Occasionally, the stimulation may induce side effects such as difficulty with eye lid opening, double vision, tingling sensations, and involuntary movements such as chorea, all of which can be alleviated by adjusting stimulation settings.
• These are mechanical devices. Wires may break or disconnect. Batteries will certainly need to be changed. All of these repairs require surgery. Breakage of the brain lead requires implantation of a new one.