Objective: To measure volume changes of a brain cyst following deep brain stimulation (DBS) implantation as a potential biomarker of the outcome.

Background: A brain cyst is a rare complication of electrode insertion which potentially causes severe side effects including the failure of DBS therapy. The etiology and mechanisms of cyst development are still unknown. Up to now, there is generally no recommended treatment for this complication.  Revision surgery or steroid therapy were found to be effective in a few cases in which the cysts were accompanied by clinical symptoms. (1)

Method: Three patients (1F, 2M) suffering from dystonia (1 DYT1, 1 Meige’s syndrome, 1 cervical dystonia) underwent DBS implantation of quadripolar electrodes into the globus pallidus internus bilaterally. An intraparenchymal cyst near one of the electrodes was unexpectedly detected on a routine 3T MRI (Skyra, Siemens, Erlangen, Germany) performed after surgery. A series of 2-5 additional MRI were longitudinally acquired to monitor further development. The volume of the cyst was measured with xVision software.

Results: Spontaneous regression of the cyst volume was observed in all three patients (- 28.3%, – 30.3%, – 9.8%). (Fig.1) One of the patients underwent a surgical revision due to a DBS malfunction initially accompanied by a temporary cyst volume increase (+ 48.7%) and finally followed by a volume regression (- 12.8%).

Conclusion: We demonstrated the dynamics of intraparenchymal cysts after DBS surgery and showed that these cysts tend to spontaneously reduce in volume. On the other hand, repeated surgery could cause progression of the cyst volume with no clear clinical impact.

References: 1) Staudt MD, MacDougall KW. Spontaneous Regression of an Intraparenchymal Cyst Following Deep Brain Stimulator Electrode Implantation: Case Report and Literature Review. World Neurosurg. 2018 Sep;117:249-254. doi: 10.1016/j.wneu.2018.06.115. Epub 2018 Jun 22

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MDS Abstracts - https://www.mdsabstracts.org/abstract/spontaneous-volume-regression-of-a-brain-cyst-after-dbs-surgery/