Subdural electrode-associated complications: A 20-year experience

Background: Implantation of subdural strip and grid electrodes is a common methodology in the invasive evaluation of patients with medically refractory epilepsy. Although their implantation is safe, the occurrence of implantation-associated complications can occasionally be troublesome. Methods: In our current retrospective study, 185 patients undergoing subdural grid/strip implantation for invasive monitoring were examined. Their ages ranged between 16 and 48 years ( mean 23.6). AdTech (Racine, Wisc., USA) strip and grid electrodes were implanted under general endotracheal anesthesia in all our cases. Duration of electroenceph-alographic monitoring ranged from 2 to 25 days ( mean 10.8). The follow-up period ranged from 24 to 60 months ( mean 44.6 months). Results: The most common complication in our series was the development of postoperative epidural hematoma in 3 patients (1.6%), while 2 patients (1.1%) suffered a subdural hematoma. Two patients (1.1%) developed significant brain edema postoperatively, 2 others (1.1%) developed an infection, while 2 patients (1.1%) experienced transient aphasia. Two patients (1.1%) had fatal outcomes in our series. Interestingly, in 5 patients (2.7%) nonhabitual seizures were recorded. Conclusion: Thorough understanding, early identification and prompt management of potential complications can minimize the risks associated with the implantation of subdural electrodes. Copyright (c) 2007 S. Karger AG, Basel.