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Child's Nervous System
Published in: Child's Nervous System 9/2020

01-09-2020 | Autopsy | Case-Based Review

Post-mortem histopathology of a pediatric brain after bilateral DBS of GPI for status dystonicus: case report and review of the literature

Authors: Flavio Giordano, Chiara Caporalini, Simone Peraio, Lorenzo Mongardi, Anna Maria Buccoliero, Michele Alessandro Cavallo, Lorenzo Genitori, Matteo Lenge, Regina Mura, Federico Melani, Manuela L’Erario, Leonardo Lelli, Michele Pennica

Published in: Child's Nervous System | Issue 9/2020

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Abstract

Purpose

To investigate the effects of deep brain stimulation (DBS) electrodes on the brain of a dystonic pediatric patient submitted to bilateral DBS of the globus pallidus internus (GPI).

Methods

An 8-year-old male patient underwent bilateral DBS of GPI for status dystonicus. He died 2 months later due to multiorgan failure triggered by bacterial pneumonia. A post-mortem pathological study of the brain was done.

Results

At visual inspection, no grossly apparent softening, hemorrhage, or necrosis of the brain adjacent to the DBS lead tracts was detected. High-power microscopic examination of the tissue surrounding the electrode trajectories showed lymphocyte infiltration, astrocytic gliosis, microglia, macrophages, and clusters of multinucleate giant cells. Significant astrocytosis was confirmed by GFAP staining in the electrode site. The T cell lymphocyte activity was overexpressed with activated macrophages detected with CD3, CD20, CD45, and CD68 stains respectively. There was no gliosis or leukocyte infiltration away from the surgical tracks of the electrodes.

Conclusion

This is the first post-mortem examination of a child’s brain after bilateral DBS of GPI. The comparison with adult post-mortem reports showed no significant differences and confirms the safety of DBS implantation in the pediatric population too.
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Metadata
Title
Post-mortem histopathology of a pediatric brain after bilateral DBS of GPI for status dystonicus: case report and review of the literature
Authors
Flavio Giordano
Chiara Caporalini
Simone Peraio
Lorenzo Mongardi
Anna Maria Buccoliero
Michele Alessandro Cavallo
Lorenzo Genitori
Matteo Lenge
Regina Mura
Federico Melani
Manuela L’Erario
Leonardo Lelli
Michele Pennica
Publication date
01-09-2020
Publisher
Springer Berlin Heidelberg
Published in
Child's Nervous System / Issue 9/2020
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-020-04761-w

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