Determining the incidence and clinical relevance of early post-surgery peri-lead edema (PLE) as well as the long-term persistence in DBS-patients.

We conducted a retrospective analysis of all patients implanted with a deep brain stimulation (DBS) system since 2021 (n = 46). Indications for DBS-implantation were Parkinsons disease (36 patients), cervical dystonia (three patients) and essential tremor (seven patients). A total of 46 patients and 92 leads were included in the analysis. The occurrence of PLE was analyzed in an early postoperative computer tomography (CT), done 1-12 days after surgery, as well as a secondary CT, performed in an interval of 3 – 13.7 months after the implantation.

Early postoperative CT-scans were conducted in 15 patients, totaling to 30 leads being analyed. PLE at this stage was detected at 15 (50%) of those leads. Seven of the patients had bilateral edema, and only one unilateral. 13 leads (86%) were implanted in the subthalamic nucleus. The other two were implanted in globus pallidus internus. No leads in the ventral intermediate nucleus of the thalamus were assessed with the early postoperative CT. All of the PLEs diagnosed in the initial CT scan had completely disappeared by the time of the secondary CT scan.

There was no overlaying clinical correspondence to the appearance of the edema. One patient preoperatively treated with oral anticoagulation developed a left frontal subcortical peri-lead bleed which led to a slight motoric aphasia. This improved completely and spontaneously. Another patient described a light postoperative headache, which is not an uncommon occurrence. None of the patients which developed PLE needed surgical treatment.

The secondary CT scan showed PLE in a total of four patients, in each case unilaterally. None of these patients exhibited any surgical complications and all described a clinical benefit following the dbs implantation.

Although common in the early postoperative period, the analysis shows that PLE is a reversible occurrence and should not be viewed as a postoperative complication or an indicator of an intracerebral infection.