{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:20:27Z","timestamp":1783470027627,"version":"3.55.0"},"reference-count":62,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,7,6]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Delayed symptomatic postoperative intracranial hemorrhage (ICH) is an uncommon yet consequential complication of deep brain stimulation (DBS) device implantation surgery, previously defined as occurring after postoperative day 1 and uncommonly reported to occur months after surgery. Recognizing this entity may be critical for optimizing patient management, despite its rarity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>\n                      A 73-year-old woman with Parkinson\u2019s disease underwent bilateral subthalamic nucleus (STN) DBS device implantation without perioperative complications. She presented 4 months later after ascending by automobile to a high altitude, during which she experienced acute left facial droop, ptosis, slurred speech, balance changes, and horizontal diplopia. MRI revealed a left-sided 1-cm\n                      <jats:sup>3<\/jats:sup>\n                      hematoma at the tip of the left DBS lead, centered in the STN. She was admitted for 2 days of inpatient observation. She returned to her neurological baseline 2 weeks after discharge and remains symptomatically stable.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Delayed ICH after DBS is rarely reported, yet it can result in significant neurological deficits. Multiple etiologies may be possible for delayed ICH after DBS. This patient\u2019s exposure to high altitude at symptom onset, an independent risk factor for cerebral edema and hypercoagulability, may have contributed to this rare event.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE26401\">https:\/\/thejns.org\/doi\/10.3171\/CASE26401<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case26401","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:13:34Z","timestamp":1782864814000},"source":"Crossref","is-referenced-by-count":0,"title":["Delayed intracranial hemorrhage following deep brain stimulation for Parkinson\u2019s disease: illustrative case"],"prefix":"10.3171","volume":"12","author":[{"given":"Tulasi M.","family":"Iyengar","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cody B.","family":"Wolfe","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0426-3241","authenticated-orcid":true,"given":"Nader","family":"Pouratian","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"2","key":"bib1","series-title":"J Neurosurg","first-page":"381","article-title":"Comprehensive characterization of intracranial hemorrhage in deep brain stimulation: a systematic review of literature from 1987 to 2023","volume":"141","author":"Cheyuo","year":"2024","unstructured":"Cheyuo CVetkas ASarica CKalia SKHodaie MLozano AM.Comprehensive characterization of intracranial hemorrhage in deep brain stimulation: a systematic review of literature from 1987 to 2023. 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