Minim Invasive Neurosurg 2011; 54(1): 48-49
DOI: 10.1055/s-0031-1273733
Technical Note

© Georg Thieme Verlag KG Stuttgart · New York

Lead Cap Localization using Ultrasound in Deep Brain Stimulation Surgery: Technical Note

D. J. Englot1 , E. F. Chang1 , P. S. Larson1
  • 1Department of Neurological Surgery, University of California, San Francisco, California, USA
Further Information

Publication History

Publication Date:
19 April 2011 (online)


In deep brain stimulation (DBS) surgery, after intracranial lead implantation, lead caps are tunneled into the subgaleal space for later connection to internal pulse generator (IPG) extension wires. In the subsequent IPG implantation procedure, the lead cap must be localized by palpation in order to plan an incision in the scalp to complete this connection. However, if the IPG implantation is done the same day as the intracranial lead implantation, palpation of the lead cap may be challenging in a thick or postoperatively edematous scalp. Manufacturers suggest using fluoroscopy in these instances, but fluoroscopy provides poor soft tissue visualization, requires further unnecessary radiation exposure to both the patient and the surgical team, and can be cumbersome. Portable ultrasound (US) machines are readily available in many operating rooms, and can be used to easily and accurately localize the lead cap prior to IPG implantation.



P. S. Larson, MD 

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