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Coming back to infections due to DBS: it really is relatedto the quality of the surgeon; if you are very carefull during surgery there will be no infections. Out of 120 patients operated in our hospital in Ghent we did not have a single case of electrode infection; only two cases of infection at the level of the clavicle. That's all. So the way the surgeon handles sterility is, I believe the most imortant factor in calculating the risk of electrode infection. Chris van der Linden, M.D. St. Lucas Hospital Ghent Belgium ----- Original Message ----- From: "Murray Charters" <[log in to unmask]> To: <[log in to unmask]> Sent: Wednesday, March 20, 2002 1:31 PM Subject: ARTICLE: Implant Patients May Suffer Infections, Hemorrhages > The Charlotte Observer > Posted on Tue, Mar. 19, 2002 > > Implant patients may suffer infections, hemorrhages > KAREN GARLOCH > Staff Writer > > The risk of infection after brain surgery is one in 100, > said Dr. Stephen Tatter, a neurosurgeon at > Wake Forest University. > > But deep brain stimulation -- the new operation for > Parkinson's disease symptoms -- is more risky because > it involves implanting foreign objects. Electrodes are > implanted deep in the brain. A stimulator goes in the > chest near the collarbone. And a wire connects the two. > > Prior to approval by the federal Food and Drug > Administration, a study of deep brain stimulation found > that 17 of 160 enrolled patients, or 10.6 percent, > experienced at least one device-related infection and > several had more than one. In nine of the 17, the infection > resulted in removal of at least part of the implant. > > In a separate study, reported in the New England Journal > of Medicine in September, two of 143 patients had the > implant removed because of infection. > > Tatter said three of his 100 patients who've had deep > brain stimulation developed infections, including one > who developed an infection twice. > > Charlotte patient Deborah Setzer, who had the surgery > in December, was the first with an infection in the brain. > The other infections had involved only the chest > stimulator or the wire. Setzer's infection may have started > at the stimulator in her chest and spread up the > connecting wire, Tatter said. He removed her implants. > > Since Setzer's infection, Tatter has made changes. > > He's allowing fewer people in the operating room and less > coming and going. He's also begun telling patients not > to cut their own hair before surgery. > > Setzer had her head shaved by a beautician two days > before surgery. She also shaved it again herself the day > before. > > Tatter said he can't find studies documenting any > connection between head shaving and infection risk. > But as a resident at Massachusetts General Hospital > in Boston, he learned that there was a higher risk > of infection if patients' heads were shaved the night > before surgery than if they were shaved that morning. > > "It's just better to be on the extra-cautious side," he said. > > The other major complication of deep brain stimulation > is hemorrhage, or bleeding. In the study leading to FDA > approval, 12 of 160 patients, or 7.5 percent, had intracranial > hemorrhage. The study reported in the New England > Journal said intracranial hemorrhage occurred in seven > of 143 patients. Of those, two had the implant removed. > > Despite adverse side effects, the study concluded -- and > many doctors agree -- that deep brain stimulation is safer > than two decades-old operations for Parkinson's > symptoms -- pallidotomy and thalamotomy. In those > procedures, brain cells are destroyed to stop the signals > that produce symptoms of pain, stiffness and tremor. > > Unlike those procedures, deep brain stimulation is > reversible. > > "It's extremely safe," said Martin Bootin, > a neurophysiologist at Presbyterian Hospital who > consults on deep brain stimulation. "That's one > of the reasons why it's received increased popularity > over the previous surgery. > > "With these stimulators, you are causing far less > permanent damage ... There's very low risk, and you > have an increasing opportunity to optimize the > treatment after the surgery." > > SOURCE: The Charlotte Observer > http://www.charlotte.com/mld/charlotte/living/columnists/karen_garloch/28888 46.htm > > * * * > > ---------------------------------------------------------------------- > To sign-off Parkinsn send a message to: mailto:[log in to unmask] > In the body of the message put: signoff parkinsn > ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn