Seizures after Spontaneous Supratentorial Intracerebral Hemorrhage

Passero, S.; Rocchi, Raffaele; Rossi, Símone; Ulivelli, Monica; Vatti, Giampaolo

doi:10.1046/j.1528-1157.2002.00302.x

Cited by 242 publications

(190 citation statements)

References 26 publications

Supporting

Mentioning

175

Contrasting

Unclassified

Order By: Relevance

“…Epilepsy is the occurrence of repeated unprovoked seizures. 4,18 We assigned our patients to 3 groups based on seizure onset relative to the clinical ictus of spontaneous ICH. Immediate seizures were defined as occurring within 24 hours of spontaneous ICH onset, early seizures as occurring within 2 weeks of ICH, and late seizures as occurring more than 2 weeks later.…”

Section: Methodsmentioning

confidence: 99%

“…1 Epileptic seizures after spontaneous ICH have been reported in 2.8-18.7% of patients in various studies, 1,3,4,6,9,14,15,19 and seizures only in patients with strokes and cerebral hemisphere lesions. 4,18 The indications for and duration of seizure treatment required after spontaneous ICH remain controversial, although Passero et al 18 recently demonstrated that the risk of early seizures was reduced with prophylactic AED therapy in patients with lobar ICH. Some physicians consider prophylaxis with AEDs to be a standard part of care, while others are concerned about the potential adverse effects of AEDs and choose to treat seizures only when symptoms arise.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Predictors and outcome of seizures after spontaneous intracerebral hemorrhage

Yang¹,

Lin

Chang

et al. 2009

JNS

View full text Add to dashboard Cite

Object. Seizures are an important neurological complication of spontaneous intracerebral hemorrhage (ICH).A better understanding of the risk factors of seizures following ICH is needed to predict which patients will require treatment.Methods. Two hundred and forty-three adult patients were enrolled in this 1-year retrospective study. Multiple logistic regression was used to evaluate the relationship between baseline clinical factors and the presence or absence of seizure during the study period.Results. Seizures occurred in 20 patients with ICH, including acute symptomatic seizures in 9 and unprovoked seizures in 11. None progressed to status epilepticus during hospitalization. After a minimum 3-year follow-up period, the mean Glasgow Outcome Scale score was 3.8 ± 1.1 for patients who had had seizures and 3.5 ± 1.3 for those who had not. The multiple logistic regression model demonstrated that the mean ICH volume was independently as sociated with seizures, and any increase of 1 mm 3 in ICH volume increased the seizure rate by 2.7%. Conclusions. Higher mean ICH volumes at presentation were predictive of seizure, and the presence of late seizures was predictive of developing epilepsy. Most seizures occurred within 2 years of spontaneous ICH over a minimum of 3 years of follow-up. (DOI: 10.3171/2009.2.JNS081622) KeY WorDs • outcome • risk factor • seizure • spontaneous intracerebral hemorrhage 87Abbreviations used in this paper: AED = antiepileptic drug; GCS = Glasgow Coma Scale; GOS = Glasgow Outcome Scale; ICH = intracerebral hemorrhage; ROI = region of interest.

show abstract

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

Predictors and outcome of seizures after spontaneous intracerebral hemorrhage

Yang¹,

Lin

Chang

et al. 2009

JNS

View full text Add to dashboard Cite

show abstract

“…Epilepsy developed in 43% of patients affected by seizures occurring more than 2 weeks after the onset of SICH, whereas it developed in only 17% of those with seizures appearing within 2 weeks of onset. Passero, et al, 97 retrospectively reviewed data acquired in 761 patients with supratentorial SICH and reported a 30-day actuarial risk of post-SICH seizures of 8.1%. They found that the risk of early seizures in lobar SICH was reduced by prophylactic antiepileptic drug therapy.…”

Section: Medical Treatmentmentioning

confidence: 99%

Spontaneous intracerebral hemorrhage: a review

Fewel¹,

Thompson²,

Hoff³

2003

FOC

148

View full text Add to dashboard Cite

Spontaneous intracerebral hemorrhage (SICH) is a blood clot that arises in the brain parenchyma in the absence of trauma or surgery. This entity accounts for 10 to 15% of all strokes and is associated with a higher mortality rate than either ischemic stroke or subarachnoid hemorrhage. Common causes include hypertension, amyloid angiopathy, coagulopathy, vascular anomalies, tumors, and various drugs. Hypertension, however, remains the single greatest modifiable risk factor for SICH. Computerized tomography scanning is the initial diagnostic modality of choice in SICH, and angiography should be considered in all cases except those involving older patients with preexisting hypertension in thalamic, putaminal, or cerebellar hemorrhage. Medical management includes venous thrombosis prophylaxis, gastric cytoprotection, and aggressive rehabilitation. Anticonvulsant agents should be prescribed in supratentorial SICH, whereas the management of hypertension is controversial. To date, nine prospective randomized controlled studies have been conducted to compare surgical and medical management of SICH. Although definitive evidence favoring surgical intervention is lacking, there is good theoretical rationale for early surgical intervention. Surgery should be considered in patients with moderate to large lobar or basal ganglia hemorrhages and those suffering progressive neurological deterioration. Elderly patients in whom the Glasgow Coma Scale score is less than 5, those with brainstem hemorrhages, and those with small hemorrhages do not typically benefit from surgery. Patients with cerebellar hemorrhages larger than 3 cm, those with brainstem compression and hydrocephalus, or those exhibiting neurological deterioration should undergo surgical evacuation of the clot. It is hoped that the forthcoming results of the International Surgical Trial in IntraCerebral Hemorrhage will help formulate evidence-based recommendations regarding the role of surgery in SICH.

show abstract

“…There was also a trend toward poorer functional outcome at discharge [116]. Treatment with antiepileptic drugs (AEDs) in lobar ICH patients is associated with a decrease in the number of clinically detectable seizures, which in theory should be beneficial [117]. However, AEDs have not been shown to improve outcome, and in fact may be associated with worse outcomes in unselected ICH patients [118,119].…”

Section: Seizuresmentioning

confidence: 99%