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Case 32 - Preoperativeevaluation for deep brain stimulator surgery

from Section I - Neuroanesthesia

Published online by Cambridge University Press:  03 May 2011

By
Milind Deogaonkar
Edited by
George A. Mashour  and
Ehab Farag
George A. Mashour
Affiliation:
University of Michigan
Ehab Farag
Affiliation:
Cleveland Clinic
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Summary

Deep brain stimulation surgery for Parkinson's disease requires a systematic approach to preoperative assessment. The success of deep brain stimulation (DBS) surgery depends on proper patient selection, proper placement of the DBS electrode in the intended nucleus and proper programming. In view of this, the preoperative evaluation of the DBS patient assumes added importance. This chapter presents a case study of a 65-year-old male who was to be evaluated for DBS surgery. An awake intubation was performed and intraoperative electrophysiologic monitoring was employed during the surgery. This case highlights the following important preoperative evaluation issues in DBS patients: general surgical patient evaluation, disease-specific evaluation, neuropsychological evaluation, evaluation of associated medical conditions and airway evaluation. The neuropsychological assessment should include assessment of cognition, neuropsychiatric symptoms, social support, and goals for surgery. Understanding the medical and neuropsychological considerations of Parkinson's disease is essential for proper perioperative care.

Keywords

retroperitoneal surgeryfemoral neuropathyiatrogenic injuriesretroperitoneal hematomastent-graftingendovascular therapycomputed tomographyangiography
Type
Chapter
Information
Case Studies in Neuroanesthesia and Neurocritical Care , pp. 103 - 105
Publisher: Cambridge University Press
Print publication year: 2011

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