Displacement of the deep brain stimulation electrodes implanted in the anterior nucleus of the thalamus due to chronic subdural hematoma

Michał Sobstyl; Karol S. Karamon; Ewa Nagańska; Tadeusz Pietras; Aleksandra Wierzbicka

doi:10.5114/fn.2025.154802

eISSN: 1509-572x
ISSN: 1641-4640

Folia Neuropathologica

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3/2025
vol. 63

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abstract:

Case report

Displacement of the deep brain stimulation electrodes implanted in the anterior nucleus of the thalamus due to chronic subdural hematoma

Michał Sobstyl

¹

,

Karol S. Karamon

²

,

Ewa Nagańska

³

,

Tadeusz Pietras

⁴

,

Aleksandra Wierzbicka

⁵

Department of Neurosurgery, Institute of Psychiatry and Neurology, Warsaw, Poland
Department of Neuroradiology, Institute of Psychiatry and Neurology, Warsaw, Poland
Department of Neurology and Epileptology, Independent Public Clinical Hospital, Medical Center for Postgraduate Education, Warsaw, Poland
2nd Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
Department of Neurophysiology, Institute of Psychiatry and Neurology, Warsaw, Poland

Folia Neuropathol 2025; 63 (3): 313-319

DOI: https://doi.org/10.5114/fn.2025.154802

Online publish date: 2025/09/30

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Anterior nucleus of the thalamus deep brain stimulation (ANT DBS) offers a treatment option for patients with drug-resistant epilepsy (DRE). This treatment modality is particularly useful in cases of multifocal DRE originating from the frontal and temporal lobes. Here we present a 36-year-old epileptic patient who underwent ANT DBS implantation. The incidence of seizures dropped significantly after surgery, though the patient still experienced occasional seizure episodes. After 9 months, the patient sustained a head injury due to bilateral tonic-clonic seizures (BTCS), leading to the development of a chronic subdural hematoma (cSDH) and subsequent displacement of the ANT DBS electrodes. Following the evacuation of the left cSDH, MRI revealed properly positioned DBS electrodes, with no need for additional adjustments. The follow-up period was uncomplicated, showing a 68% reduction in focal impaired awareness seizures (FIAS) and an 80% reduction in BTCS at 24 months. To our knowledge, this is the first report of a patient who developed a cSDH with subsequent displacement of both DBS leads implanted in the ANT.

keywords:

Displacement of the deep brain stimulation electrodes implanted in the anterior nucleus of the thalamus due to chronic subdural hematoma

Michał Sobstyl 1 , Karol S. Karamon 2 , Ewa Nagańska 3 , Tadeusz Pietras 4 , Aleksandra Wierzbicka 5

deep brain stimulation, neuromodulation, chronic subdural hematoma, epilepsy, anterior thalamic nuclei

Michał Sobstyl

¹

,

Karol S. Karamon

²

,

Ewa Nagańska

³

,

Tadeusz Pietras

⁴

,

Aleksandra Wierzbicka

⁵