Deep brain stimulation's anatomy: step by step evaluation of the extracerebral surgical technique

Introduction Our purpose was to study the surgical anatomy of the deep brain stimulation technique, focusing on the extracerebral part of this minimally invasive procedure. Materials and methods Our study was based on four formalinembalmed adult human cadavers from cadaver donors. We created a set of deep brain stimulation-like materials for the extracerebral technique and formed a step by step diagram of the extracerebral surgical procedure. We also studied the course of the supraorbital nerve. Results A small intermediate incision at the midpoint of each tunnel significantly helps in decreasing the procedure’s duration and risks. The lateral limit of the subclavicular pocket’s incision must be vertical to the cervical tunnel axis in order to avoid accidental traumatism during tunneling. Information regarding the supraorbital nerve and skin landmarks of the head, for safer pins or fiducials’ placement, is also provided. Conclusion The extracerebral surgical technique hides uncommon anatomical details and difficult technical points. Their knowledge can help neurosurgeons in decreasing the observed complication rates.