Predictors and outcome of seizures after spontaneous intracerebral hemorrhage. Clinical article

J Neurosurg. 2009 Jul;111(1):87-93. doi: 10.3171/2009.2.JNS081622.

Abstract

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 associated with seizures, and any increase of 1 mm3 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.

MeSH terms

  • Acute Disease
  • Adult
  • Age of Onset
  • Aged
  • Aged, 80 and over
  • Cerebral Hemorrhage / diagnostic imaging
  • Cerebral Hemorrhage / epidemiology*
  • Epilepsy / diagnostic imaging
  • Epilepsy / epidemiology*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • Tomography, X-Ray Computed
  • Young Adult