Subacute Subdural Hematoma in a Patient with Bilateral DBS Electrodes

Abstract EN

Subdural hematomas (SDH) in patients with implanted deep brain stimulating (DBS) electrodes are rare.

Only a handful of cases have been reported in the literature.

No clear management guidelines exist regarding the management of the hematoma and the existing electrodes.

We describe a 68-year-old female with bilateral DBS electrodes, who presented with acute, severe hemiparesis due to a large subacute SDH with associated electrode displacement.

Urgent hematoma evacuation reversed the hemiparesis; the electrodes were left undisturbed.

Brain reexpansion occurred promptly.

The patient was able to benefit from stable DBS therapies within 3 weeks of hematoma evacuation, maintained at 1.5-year follow-up.

The case highlights that despite relative electrode migration due to a subdural hematoma, the electrodes may not require revision during initial hematoma evacuation or in a delayed fashion.

Timely hematoma evacuation, coupled with brain reexpansion, may be adequate for the electrode to travel back to its original position and effect reasonable DBS therapies.