• Daniel R Kramer, Casey H Halpern, Shabbar F Danish, Jurg L Jaggi, and Gordon H Baltuch.
• University of Pennsylvania, Center for Functional and Restorative Neurosurgery, Pennsylvania Hospital, Philadelphia, PA 19106, USA.
• Stereotact Funct Neurosurg. 2012 Jan 1; 90 (1): 20-4.

BackgroundBrain shift during deep brain stimulation (DBS) surgery may compromise target localization. Loss of cerebrospinal fluid is believed to be the underlying mechanism, thus an intraventricular trajectory during DBS surgery may be associated with increased shift, in addition to other complications, such as intraventricular hemorrhage.ObjectiveWe set out to assess the effect of traversing the lateral ventricle on brain shift during DBS surgery.MethodsWe performed a retrospective review of 65 pre- and postoperative MR images of patients who underwent bilateral subthalamic nucleus deep brain stimulator placement to treat advanced Parkinson's disease. Patients were separated into two groups: Group A (intraventricular trajectory, n = 46) and Group B (no intraventricular trajectory, n = 19). In these patients, we compared pre- and postoperative frame coordinates of the red nucleus (RN).ResultsGroup B demonstrated significantly more posterior shift of the center of the RN (1.40 ± 1.32 mm) than Group A (0.64 ± 1.76 mm; p < 0.02). We found no increase in incidence of intraventricular hemorrhage or the number of microelectrode trajectory attempts.ConclusionsIntraventricular trajectories during DBS surgery do not appear to compromise safety or targeting accuracy.Copyright © 2011 S. Karger AG, Basel.

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