Editing Deep brain stimulation (section)

====Post operative complications====
The overall rate of intracranial hemorrhage at surgery is 5%, with symptomatic hemorrhage in 2% and hemorrhage causing permanent deficit or death in 1%. Stroke occurred in 1%, infection in 8%, lead erosion without infection in 2%, lead fracture in 8%, lead migration in 10%, and death in 2%.<ref name="An update on best practice of deep">{{cite journal |last1=Hartmann |first1=CJ |last2=Fliegen |first2=S |last3=Groiss |first3=SJ |last4=Wojtecki |first4=L |last5=Schnitzler |first5=A |title=An update on best practice of deep brain stimulation in Parkinson's disease. |journal=Therapeutic Advances in Neurological Disorders |date=2019 |volume=12 |page=1756286419838096 |doi=10.1177/1756286419838096 |pmid=30944587|pmc=6440024 }}</ref> Additional adverse events include the need for revision in 5%, lead malposition 3%, surgical site complications 3%, hardware-related complications 2%, and seizure 2%. There was a significant non-linear increase with each additional track, for example in situations when leads needed to be repositioned or in multiple target procedures.<ref>{{cite journal |last1=Rasiah |first1=NP |last2=Maheshwary |first2=R |last3=Kwon |first3=CS |last4=Bloomstein |first4=JD |last5=Girgis |first5=F |title=Complications of Deep Brain Stimulation for Parkinson Disease and Relationship between Micro-electrode tracks and hemorrhage: Systematic Review and Meta-Analysis. |journal=World Neurosurgery |date=March 2023 |volume=171 |pages=e8–e23 |doi=10.1016/j.wneu.2022.10.034 |pmid=36244666}}</ref>

In the short term, studies have reported a risk of cerebral hemorrhage of 1.4%, hardware infection 1.1%, post operative mental status change occurred in 4.6%, and seizure occurred in 1.4%; in the longer term adverse events include confusion at 3.9%, hardware infection at 4.5%, implantable pulse generator malfunction 1.4%.<ref name="Zhang 2022"/>

Image guided lead placement tends to have shorter surgical times and lower rates of intracranial hemorrhage. Combined methods that use both microelectrode recording and image guidance are not as brief in operating room time and have a higher risk of hemorrhage, but result in more accurate lead placement.<ref>{{cite journal |last1=Yin |first1=Z |last2=Luo |first2=Y |title=Is awake physiological confirmation necessary for DBS treatment of Parkinson's disease today? A comparison of intraoperative imaging, physiology, and physiology imaging-guided DBS in the past decade. |journal=Brain Stimulation |date=July 2019 |volume=12 |issue=4 |pages=893–900 |doi=10.1016/j.brs.2019.03.006 |pmid=30876883}}</ref>