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LEAD MALPOSITION: THE HIDDEN CAUSE
- Before blaming programming, reconstruct the lead
- LEAD CHECK
- ON TARGET OFF TARGET
- POOR RESPONSE → LOCALIZE THE FAILURE
- IMAGE — Postoperative CT/MRI → reconstruct lead coordinates.
- REGISTER — Fuse to preoperative MRI/atlas.
- ORIENT — Confirm depth and directional orientation.
- ANATOMY — Measure relationship to target + nearby structures.
- PROGRAM — Ask whether the available contacts can still recruit the desired field.
- REVISE? — Only after the anatomical and programming diagnosis is clear.
- Pearl: “Good MER” does not prove “optimal implanted lead.” Final lead reconstruction is essential.
- Dr Vikas Kathuria | MCh Neurosurgery
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44A POSTOPERATIVE LEAD MALPOSITION CT/MRI — INSERT AUTHENTIC IMAGE
Real clinical image required
Image typeComplication imaging
DescriptionAuthentic published or institutional imaging only. Never fabricate lead-localization results.
Clinical purposeSupport fellowship-level interpretation without fabricating patient imaging, wound photographs or lead-localization results.
Suggested sourceINSERT AUTHENTIC PUBLISHED / INSTITUTIONAL IMAGE HERE (licensing and consent confirmed)
Copyright statusSource, consent and reproduction rights must be confirmed before use.
CaptionTo be written with the final image
AssociationModule 09 · Slide 44
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44B LEAD RECONSTRUCTION FUSED TO PREOPERATIVE MRI — INSERT AUTHENTIC IMAGE
Real clinical image required
Image typePostoperative lead reconstruction
DescriptionGenuine reconstruction from an institutional or published dataset, with permission.
Clinical purposeSupport fellowship-level interpretation without fabricating patient imaging, wound photographs or lead-localization results.
Suggested sourceINSERT AUTHENTIC PUBLISHED / INSTITUTIONAL IMAGE HERE (licensing and consent confirmed)
Copyright statusSource, consent and reproduction rights must be confirmed before use.
CaptionTo be written with the final image
AssociationModule 09 · Slide 44