Affiliations: [a] Department of Neuroscience, Graduate School, College of Medicine, Chungbuk National University, Cheongju, Republic of Korea
| [b] Department of Neurosurgery, Chungbuk National University Hospital, Cheongju, Republic of Korea
| [c] Department of Orthopedic Surgery, Chungbuk National University Hospital, Cheongju, Republic of Korea
| [d] Department of Neurosurgery, Gamma Knife Icon Center, Chungbuk National University Hospital, Cheongju, Republic of Korea
| [e] Institute for Stem Cell & Regenerative Medicine (ISCRM), Chungbuk National University, Cheongju, Republic of Korea
Correspondence to: Young Seok Park, MD, PhD, Associate Professor, Department of Neurosurgery, Chungbuk National University Hospital, NeuroFuture Lab, Chungbuk National University, College of Medicine, Chungbuk National University, 776, 1 Sunhwan-ro, Gaesin-dong, Sewon-gu, Cheongju 28644, Republic of Korea. Tel.: +82 43 269 6080; Fax: +82 43 273 1614; E-mail: [email protected].
Abstract: Background:Scalp erosion is not an uncommon complication of deep brain stimulation (DBS) surgery. Although various methods have been proposed to prevent and manage complications, there are still challenges. We introduce a case of recurrent scalp erosion after DBS surgery treated with vacuum-assisted closure. Case description:This article reports the case of a patient who underwent DBS for advanced Parkinson’s disease and suffered from recurrent scalp erosion with device extrusion through the skin. Scalp erosion occurred 2 years after DBS and repeated improvement and deterioration despite scalp reconstruction using a skin flap. We opened the wound and performed temporal muscle reconstruction to cover the burr hole site, and we changed the exposed cable and applied vacuum-assisted closure. During the follow-up period, no signs of erosion or infection occurred, and DBS efficacy was preserved. Conclusion:To date, the available management strategies for scalp erosion after DBS are revision with debridement and scalp reconstruction using skin flaps or skin grafts. However, if erosion occurs repeatedly despite the above management strategies, vacuum-assisted closure with temporalis muscle reconstruction could be a suitable option. We suggest that if the condition of the scalp is weakened, it is worth considering this approach preferentially.