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Management of peri-lead cyst after Deep Brain Stimulation surgery: Review of literature and an illustrative case report

V. Srinivasa Rangan, . (Hyderabad, India)

Meeting: 2025 International Congress

Keywords: Deep brain stimulation (DBS), Parkinson’s

Category: Parkinson's Disease: Surgical Therapy

Objective: Identification and management of an unusual complication following Deep Brain Stimulation surgery (DBS).

Background: DBS is a well established treatment modality that has found its well deserved place in the management of Parkinson’s disease. It is generally considered a minimally invasive and safe procedure with fairly few severe complications. The possible post operative complications related to the surgical procedure and implanted hardware include infection, haemorrhage, seizures, fluid collection / leak, migration / exposure of the implants, etc. Postoperative peri-lead oedema is a documented phenomenon in some cases. Peri-lead cyst formation is a rare complication following DBS surgery and it has been managed in different ways in the reported literature.

Method: One such case of peri-lead cyst development as well as a review of the relevant literature is presented here.

Results: A patient with Idiopathic Parkinson’s disease underwent DBS at our institute with electrode placement in the SubThalamic Nuclei (STN) bilaterally. Three months after lead implantation, the patient developed new disabling neurological deficits. Diagnostic imaging showed a cystic lesion along the electrode tip abutting the thalamus, internal capsule and the midbrain. Conservative management with oral dexamethasone therapy yielded no clinical improvement. The patient underwent neuro-navigation guided cyst aspiration following which he showed clinical improvement and cyst resolution on imaging. The clinical improvement of the patient was stable at three months’ follow up.

Conclusion: Unusual complications are best dealt with logical solutions applied on a case to case basis. An illustrative example of this is the successful neuro-navigation guided aspiration of a late post-operative deep brain cyst without disturbing the original DBS implant.

To cite this abstract in AMA style:

V. Srinivasa Rangan, . . Management of peri-lead cyst after Deep Brain Stimulation surgery: Review of literature and an illustrative case report [abstract]. Mov Disord. 2025; 40 (suppl 1). https://www.mdsabstracts.org/abstract/management-of-peri-lead-cyst-after-deep-brain-stimulation-surgery-review-of-literature-and-an-illustrative-case-report/. Accessed October 5, 2025.
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