{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T05:22:08Z","timestamp":1761196928576},"reference-count":12,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2001,6]]},"abstract":"<jats:p content-type=\"fine-print\">\u2713 The treatment of essential tremor with thalamic deep brain stimulation (DBS) is considered to be more effective and to cause less morbidity than treatment with thalamotomy. Nonetheless, implantation of an indwelling electrode, connectors, and a generator is associated with specific types of morbidity. The authors describe three patients who required revision of their DBS systems due to lead breakage. The connector between the DBS electrode and the extension wire, which connects to the subclavicular pulse generator, was originally placed subcutaneously in the cervical region to decrease the risk of erosion through the scalp and to improve cosmesis. Three patients presented with fractured DBS electrodes that were located in the cervical region near the connector, necessitating reoperation with stereotactic retargeting and placement of a new intracranial electrode. At reoperation, the connectors were placed subgaleally over the parietal region.<\/jats:p>\n<jats:p content-type=\"fine-print\">Management of these cases has led to modifications in the operative procedure designed to improve the durability of DBS systems. The authors recommend that surgeons avoid placing the connection between the DBS electrode and the extension wire in the cervical region because patient movement can cause microfractures in the electrode. Such microfractures require intracranial revision, which may be associated with a higher risk of morbidity than the initial operation. The authors also recommend considering prophylactic relocation of the connectors from the cervical area to the subgaleal parietal region to decrease the risk of future DBS electrode fracture, which would necessitate a more lengthy procedure to revise the intracranial electrode.<\/jats:p>","DOI":"10.3171\/jns.2001.94.6.1010","type":"journal-article","created":{"date-parts":[[2009,5,13]],"date-time":"2009-05-13T17:34:58Z","timestamp":1242236098000},"page":"1010-1012","source":"Crossref","is-referenced-by-count":26,"title":["Revision of deep brain stimulator for tremor"],"prefix":"10.3171","volume":"94","author":[{"given":"Jason M.","family":"Schwalb","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Howard A.","family":"Riina","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brett","family":"Skolnick","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jurg L.","family":"Jaggi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tanya","family":"Simuni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gordon H.","family":"Baltuch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"203","DOI":"10.3171\/jns.1996.84.2.0203","article-title":"Chronic electrical stimulation of the ventralis intermedius nucleus of the thalamus as a treatment of movement disorders.","volume":"84","author":"Benabid","year":"1996"},{"key":"b2","series-title":"Lancet","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1016\/0140-6736(91)91175-T","article-title":"Long-term suppression of tremor by chronic stimulation of the ventral intermediate thalamic nucleus.","volume":"337","author":"Benabid","year":"1991"},{"key":"b3","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"140","DOI":"10.3171\/jns.2000.93.1.0140","article-title":"Long-term deep brain stimulation in a patient with essential tremor: clinical response and postmortem correlation with stimulator termination sites in ventral thalamus. 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