Retained Intracerebral Depth Electrode after Stereotactic Electroencephalography Monitoring: A Case Report

  • KAGAWA Kota
    Department of Neurosurgery, Hiroshima University Hospital Epilepsy Center, Hiroshima University Hospital
  • IIDA Koji
    Epilepsy Center, Hiroshima University Hospital
  • HASHIZUME Akira
    Department of Neurosurgery, Hiroshima University Hospital Epilepsy Center, Hiroshima University Hospital
  • SEYAMA Go
    Department of Neurosurgery, Hiroshima University Hospital Epilepsy Center, Hiroshima University Hospital
  • OKAMURA Akitake
    Department of Neurosurgery, Hiroshima University Hospital Epilepsy Center, Hiroshima University Hospital
  • ASKORO Rofat
    Epilepsy Center, Hiroshima University Hospital Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University
  • HORIE Nobutaka
    Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University

抄録

<p>Stereotactic electroencephalography (SEEG) is an increasingly popular surgical modality for localizing the epileptogenic zone. Robot-guided stereotactic electrode placement has been covered in Japan by National Health Insurance since 2020. However, several surgical devices, such as the anchor bolt (a thin, hollow, metal shaft that serves as a guide screw or fixing for each electrode), have not been approved. A 14-year-old female who underwent SEEG for intractable epilepsy and required additional surgery to remove a retained depth electrode from the skull after the SEEG monitoring was finished. She had uncontrolled focal seizures consisting of nausea and laryngeal constriction at the onset. After a comprehensive presurgical evaluation, robot-guided stereotactic electrode implantation was performed to evaluate her seizures by SEEG. Nine depth electrodes were implanted through the twist drill hole. The electrodes were sutured to her skin for fixation without anchor bolts. When we attempted to remove the electrodes after 8 days of SEEG monitoring, one of the electrodes was retained. The retained electrode was removed through an additional skin incision and a small craniectomy under general anesthesia. We confirmed narrowing of the twist drill hole pathway in the internal table of the skull due to osteogenesis, which locked the electrode. This complication might be avoided if an anchor bolt had been used. This case report prompts the approval of the anchor bolts to avoid difficulty in electrode removal. Moreover, approval of a depth electrode with a thinner diameter and more consistent hardness is needed.</p>

収録刊行物

  • NMC Case Report Journal

    NMC Case Report Journal 11 (0), 49-53, 2024-12-31

    一般社団法人 日本脳神経外科学会

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