Postoperative use of steroids for peri‐electrode edema after deep brain stimulation surgery: A retrospective cohort study

Abstract

AbstractBackgroundTo review the incidence and extent of peri‐electrode edema after DBS and to clarify the effect of postoperative use of steroids on the peri‐electrode edema.MethodsThis retrospective cohort study included 250 patients who underwent bilateral subthalamic nucleus (STN) DBS surgery with intact MRI within 1 month after DBS surgery. Patients were divided into steroid and non‐steroid groups, based on postoperative steroids use. The occurrence and extent of peri‐electrode edema were compared between the two groups, and other associated factors were analyzed using univariate and multivariate methods.ResultsPeri‐electrode edema >1 cm3 in at least one hemisphere was reported in 215 (86.00%) patients. The mean volume of peri‐electrode edema observed in the steroid group was significantly smaller than in the non‐steroid group (8.09 ± 8.47 cm3 vs 17.10 ± 16.90 cm3, p < 0.001). In the steroid group, 104 (32.91%) of the 316 implanted electrodes present with edema less than 1 cm3, whereas in the non‐steroid group, only 27 (14.67%) of the 184 implanted electrodes present with edema less than 1 cm3 (p < 0.001). Multivariate analysis indicated that lesser peri‐electrode edema was significantly associated with postoperative steroids use and general anesthesia.ConclusionsPeri‐electrode edema is common after DBS surgery, and postoperative steroids use reduces the occurrence and extent of peri‐electrode edema.