# Successful Management of Acute Subdural Hematoma in Deep Brain Stimulation Patient: A Case Report and Literature Review

## TL;DR

A Parkinson's patient with deep brain stimulation developed a brain bleed, which was successfully treated while preserving the implanted device.

## Contribution

Demonstrates successful endoscopic hematoma evacuation preserving DBS electrodes in a long-term patient.

## Key findings

- Endoscopic evacuation preserved DBS system and allowed electrode realignment.
- Patient showed significant clinical improvement after hematoma removal.
- ASDH can cause electrode displacement but is manageable with minimally invasive surgery.

## Abstract

Deep brain stimulation (DBS) has emerged as an important therapeutic option for several movement disorders; however, the management of acute complications, such as acute subdural hematoma (ASDH), remains challenging.

This is the case of a 71-year-old woman with Parkinson’s disease who developed ASDH 12 years after bilateral DBS placement. On admission with altered consciousness, imaging revealed significant displacement of the DBS electrodes because of the hematoma. Emergent craniotomy with endoscopic evacuation was performed with preservation of the DBS system. Postoperatively, complete evacuation of the hematoma was confirmed, and the patient experienced significant clinical improvement.

ASDH causes significant electrode displacement in patients undergoing DBS. After hematoma evacuation, the electrodes were observed to return to their proper position, and the patient exhibited a favorable clinical response to stimulation. To preserve the DBS electrodes, endoscopic hematoma evacuation via a small craniotomy may be useful.