The history of surgical treatment of Parkinson's disease (PD) covers more than 100 years. It started from lesional approach and evolved to the final deep brain stimulation (DBS) only in the 1990s. The aim of this treatment was to reduce clinical manifestation of PD and drug intake by acting directly on the altered motor pathways. The typical targets are represented by ventralis intermedius thalamic nucleus (VIM), internal globus pallidus nucleus (GPi), and subthalamic nucleus (STN) with more recent extension on other anatomical structures as pedunculopontine nucleus (PPN). Patients are selected according to CAPSIT protocol and undergo DBS when medical treatment has failed to effectively control the symptoms. Clinical benefits are represented by the reduction of “off” time and “on” time with dyskinesia. However, even DBS treatment is characterized by complications and side effects, as intracerebral hemorrhages, infections, ischemia, and seizures. The recent introduction of neuronavigation systems and the amelioration in neuroradiological imaging quality simplified preoperative DBS planning and consequently reduced surgical‐related problems
Part of the book: Challenges in Parkinson's Disease