How Is Brain Pacemaker Surgery Performed?

Prof. Dr. Ömür Günaldı

How Is Brain Pacemaker Surgery Performed?

Brain pacemaker surgery has emerged in recent years as one of the most advanced medical technologies in the treatment of neurological diseases. It is successfully used in Parkinson’s disease, essential tremor (involuntary shaking), dystonia (muscle contractions), and some psychiatric disorders.

This surgery works by delivering low-voltage electrical stimulation through thin electrodes placed in the brain. In this way, abnormal brain activity is regulated and the symptoms of the disease are significantly controlled.

A highly experienced neurosurgeon, Prof. Dr. Ömür Günaldı, emphasizes the importance of this treatment by stating, “Brain pacemaker surgery does not eliminate the root cause of the disease, but it dramatically improves quality of life.”

Purpose of Brain Pacemaker Surgery

The main goal of brain pacemaker surgery is to regulate abnormal electrical activity in the deep regions of the brain.

In Parkinson’s disease and similar disorders, communication between nerve cells becomes disrupted. This disruption leads to symptoms such as slowed movement, tremor, and muscle rigidity. The brain pacemaker system restores the brain’s natural rhythm by reorganizing this communication.

Prof. Dr. Ömür Günaldı explains, “A brain pacemaker is not a device that heals the brain, but a regulator that balances brain functions.”

Who Is a Candidate for Brain Pacemaker Surgery?

Not every patient is suitable for brain pacemaker surgery. Comprehensive neurological and psychiatric evaluations are required before the procedure.

Suitable candidates generally include

Parkinson’s patients whose symptoms cannot be controlled with medication
Patients with severe tremor
Individuals with dystonia
Patients with medication-resistant obsessive-compulsive disorder

Before deciding on surgery, Prof. Dr. Ömür Günaldı carefully evaluates the patient’s age, general health condition, brain structure, and duration of the disease.

Preparation Before Brain Pacemaker Surgery

The preparation phase is one of the most critical factors affecting the success of the operation.

Neurological Evaluation

The patient’s movements, reflexes, and tremor severity are examined in detail.

Imaging Tests

Brain MRI and CT scans are used to identify the exact locations where the electrodes will be placed.

Psychological and Neuropsychological Tests

Since the brain pacemaker can affect mental processes, the patient’s psychological condition is also evaluated.

Surgical Planning

The surgical team plans the exact brain targets, such as the subthalamic nucleus or globus pallidus internus.

Prof. Dr. Ömür Günaldı states, “Fifty percent of the success of the surgery depends on proper planning.”

How Is Brain Pacemaker Surgery Performed?

Brain pacemaker surgery is performed using advanced microsurgical techniques and special imaging systems.

General Structure of the Operation

The procedure is usually performed in two stages

Placement of electrodes in the brain
Placement of the pacemaker in the chest

These steps may be done on the same day or in separate sessions depending on the patient.

Type of Anesthesia

The first stage is usually performed as awake brain surgery. The patient remains conscious but does not feel pain. This allows the surgeon to confirm accurate electrode placement.

Prof. Dr. Ömür Günaldı describes awake brain surgery as “the safest and most precise method.”

Opening the Skull

Small holes, less than 1 cm, are created in the skull. Electrodes are inserted through these openings using special guidance systems.

This step requires millimetric precision. Brain navigation systems and microelectrode recordings ensure accurate placement.

Electrode Placement

The electrodes are placed in deep brain regions to regulate abnormal signals. Each electrode contains multiple contact points that deliver controlled electrical stimulation.

Prof. Dr. Ömür Günaldı analyzes brain signals during surgery to ensure optimal placement.

Placement of the Pacemaker

In the second stage, the patient is usually under general anesthesia. A small pocket is created under the skin in the chest area, and the pacemaker is implanted.

The connecting wires run under the skin to the brain electrodes.