Abstracts

Implantation of subdural strip and grid electrodes represents a common methodology in the invasive evaluation of patients with medically refractory epilepsy. Although in the vast majority of cases their implantation is safe, the occurrence of implantation-associated complications can be occasionally troublesome. The purpose of our current communication is to identify the most commonly occurred complications and calculate their frequency in our institution., In a retrospective study, 185 patients (104 males and 81 females) undergoing subdural strip/grid electrode implantation during a 20-year period, were examined. Their age ranged between 16 and 48 years, while their mean age was 23.6. AdTech (AdTech, Racine,WI,USA) strip and grid electrodes were used in all our cases. The anatomical location of implantation were:26 implants in orbito-frontal area, 41 in mesial frontal,14 in mesial occipital, 13 in antero-basal area, 44 in interhemispheric areas while 180 in convexity areas (4 temporo-polar, 83 parietal, 17 occipital and 76 temporal). The monitoring period ranged from 2-25 days (mean 10.8 and median 7 days)., The most commonly occurred complication in our series was the development of post-operative epidural hematoma in 3/185 (1.6%) patients, requiring emergent surgical evacuation. In 2/185 (1.1%) cases transient aphasia occurred, which was spontaneously resolved. A surgical subdural hematoma developed in 2/185 (1.1%) while in another 2/185 (1.1%) an infection occurred. Interestingly, in 2 patients (1.1%) significant brain edema was post-operatively evident; one of these patients was conservatively managed with no further consequences while the other one succumbed despite aggressive management of his intracranial hypertension. Finally, one patient developed post-operatively stiff lung syndrome secondary to aspiration and eventually expired. Another interesting observation in our series was the recording of non-habitual seizures in 5/185(2.7%) patients., Subdural electrode complications although rare can be troublesome and occasionally disastrous. Knowledge, early identification and prompt management of potential complications can minimize the risks associated with the surgical implantation of subdural electrodes.,