Madzar D, Kuramatsu J, Gollwitzer S, Lücking H, Kloska S, Hamer H, Köhrmann M, Huttner H (2014)
Publication Type: Journal article
Publication year: 2014
Publisher: Humana Press
Book Volume: 21
Pages Range: 211-9
Journal Issue: 2
DOI: 10.1007/s12028-014-9968-9
Seizures are a common complication after intracerebral hemorrhage (ICH) but there is a substantial lack of information on the long-term incidence in ICH survivors and whether post-ICH seizures affect functional long-term outcome.Over a five-year period 464 consecutive patients with spontaneous ICH were analyzed. Focussing on 1-year ICH survivors, clinical, and radiological parameters were retrieved from institutional prospective databases. The occurrence of seizures was categorized as early (<=7 days) or late (>7 days). Functional outcome was assessed by mailed questionnaires and telephone interviews, and was categorized into good vs. poor (mRS: 0-2 vs. 3-5) and favorable vs. unfavorable (mRS: 0-3 vs. 4-5). Multivariate regression models were calculated to investigate risk factors associated with post-ICH seizures including an a priori defined subgroup analysis of lobar ICH patients.Among 203 long-term ICH survivors, 19.7 % developed seizures of which 55 % occurred late. Factors associated with seizures were lobar location (OR 8.10; 95 % CI 3.04-21.59; p < 0.001), sepsis (OR 4.59; 95 % CI 1.20-17.53; p = 0.026), and history of alcohol abuse (OR 3.36; 95 % CI 1.25-9.06; p = 0.017). Subgroup analysis of lobar ICH patients revealed history of alcohol abuse as the only independent predictor of post-ICH seizures (OR 5.22; 95 % CI 1.25-21.78; p = 0.024). Functional long-term outcome among survivors was slightly worse in patients with post-ICH seizures (p = 0.059). In multivariate regression modeling for prediction of poor outcome, the parameter "post-ICH seizures" again reached a statistical trend (p = 0.065), and established parameters such as age, GCS, and hemorrhage volume were independently related to poor outcome.Post-ICH seizures among long-term ICH survivors are common and may contribute to unfavorable functional outcome. Especially lobar ICH patients with a history of alcohol abuse are at risk to develop post-ICH seizures. Therefore, this subgroup may represent a target population for a prophylactic anticonvulsive treatment approach, preferably investigated in a prospective randomized trial.
APA:
Madzar, D., Kuramatsu, J., Gollwitzer, S., Lücking, H., Kloska, S., Hamer, H.,... Huttner, H. (2014). Seizures among long-term survivors of conservatively treated ICH patients: incidence, risk factors, and impact on functional outcome. Neurocritical Care, 21(2), 211-9. https://dx.doi.org/10.1007/s12028-014-9968-9
MLA:
Madzar, Dominik, et al. "Seizures among long-term survivors of conservatively treated ICH patients: incidence, risk factors, and impact on functional outcome." Neurocritical Care 21.2 (2014): 211-9.
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