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Complications with surgery or a DBS device are rare but can happen. Potential risks include:
+ Infection Infection occurs in about three to five percent of surgeries. If this happens, it’ s most commonly around the battery. Less commonly it’ s in the scalp or brain. To avoid infection, keep incisions clean and dry and avoid touching, scratching or rubbing them. You can usually shower a few days after surgery, using soap around, but not directly on, the wound. You can let water drip over the wound but you should not submerge or soak it in water or a bath. Watch for swelling, redness, pain and fever. Treatment for infection may include removal of the battery, intravenous( IV) antibiotics and, once infection clears, insertion of a new battery. If infection doesn’ t spread or start in the brain, leads can stay in place. If the brain is involved, leads may need to be removed and later reimplanted.
+ Bleeding Bleeding can happen in the brain or around the battery. Brain bleeding occurs in one to three percent of surgeries. If it occurs, it’ s most likely during or right after surgery, and it’ s seen on the CT scan done immediately following surgery. Bleeding is usually minor and resolves on its own. If it’ s more significant, it could cause weakness, language problems or a seizure. Treatment ranges from observation to an operation to remove blood. It depends on where and how big the bleed is and what, if any, symptoms it causes.
+ Suboptimal lead placement Occasionally, a brain lead is positioned outside the intended location, or it moves, or“ migrates,” from its precise target. Sometimes, the programmer can overcome this by directing stimulation to adequately control symptoms. But if this is not possible or causes too many side effects, you may need surgery to adjust the brain lead or place a new one. While not always necessary, a second opinion or input from other DBS experts may be helpful in these situations.
+ Lead break or disconnection Over time, a lead may break, or fracture, or detach from the battery. While this is more likely with specific activities that involve sudden turning, bending or twisting of the neck, it might happen without warning. You might discover this when, suddenly, symptoms return out of the blue or DBS stops working. Or, you might feel electrical shocks, which stop when the neurostimulator is turned off. If this happens, contact your DBS team immediately. They’ ll test the device and order x-rays or other imaging. Treatment may include replacement of the brain wire, extension wire and / or battery.
+ Battery migration Some people may experience slight movement of the battery over time. The battery could rotate or flip in place or gradually move sideways. If you notice a change in where or how the battery sits, contact your doctor immediately. Treatment may include a procedure to reposition and tighten the battery in place.
Potential Complications
Bleeding in the space around the battery, in the chest or abdomen, happens in three to five percent of surgeries. This would be most likely in the days or weeks following battery placement and would show up as swelling or a bubble under the skin, bruising or increased pain. Treatment may include a tight pressure bandage or, occasionally, opening the space to drain blood.
+ Skin breakdown Sometimes, the skin over the leads in the scalp, the extension wires in the neck or the battery in the chest can break down. This is called“ skin erosion.” It’ s more common in very thin people. When the skin breaks down, small portions of the hardware are exposed, increasing infection risk. Treatment may require repair or replacement of one or more pieces plus antibiotics.