Abstract:
BACKGROUND: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. METHODS: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. RESULTS: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. CONCLUSIONS: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.
journal_name
Neurocrit Carejournal_title
Neurocritical careauthors
Madžar D,Kuramatsu JB,Gollwitzer S,Lücking H,Kloska SP,Hamer HM,Köhrmann M,Huttner HBdoi
10.1007/s12028-014-9968-9subject
Has Abstractpub_date
2014-10-01 00:00:00pages
211-9issue
2eissn
1541-6933issn
1556-0961journal_volume
21pub_type
杂志文章abstract:BACKGROUND:The management of symptomatic cerebral vasospasm after aneurysmal subarachnoid hemorrhage (aSAH) can be often complicated by the presence of stunned myocardium and left ventricular failure. Vasopressors and inotropes are commonly used to optimize mean arterial pressure (MAP) and cerebral perfusion pressure (...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-010-9358-x
更新日期:2010-08-01 00:00:00
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pub_type: 杂志文章
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doi:10.1007/s12028-014-9981-z
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abstract:BACKGROUND:Impaired cerebrovascular reactivity (CR) has been reported to be associated with adverse outcome in patients with aneurysmal subarachnoid hemorrhage (aSAH). However, CR may be determined using different paradigms and it is unclear, which measurement method most suitable reflects the clinical course or is abl...
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pub_type: 杂志文章,评审
doi:10.1007/s12028-009-9287-8
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pub_type: 杂志文章,meta分析
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pub_type: 杂志文章
doi:10.1007/s12028-008-9064-0
更新日期:2008-01-01 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章
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pub_type: 杂志文章
doi:10.1007/s12028-007-0047-3
更新日期:2007-01-01 00:00:00
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pub_type: 杂志文章
doi:10.1007/s12028-016-0270-x
更新日期:2016-08-01 00:00:00
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pub_type: 杂志文章
doi:10.1007/s12028-014-0089-2
更新日期:2015-10-01 00:00:00
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pub_type: 杂志文章
doi:10.1007/s12028-014-0087-4
更新日期:2015-06-01 00:00:00
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pub_type: 杂志文章,评审
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pub_type: 杂志文章
doi:10.1007/s12028-009-9206-z
更新日期:2009-01-01 00:00:00
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pub_type: 杂志文章
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更新日期:2010-02-01 00:00:00
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pub_type: 杂志文章
doi:10.1007/s12028-007-0042-8
更新日期:2007-01-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章,评审
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更新日期:2020-08-01 00:00:00
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journal_title:Neurocritical care
pub_type: 临床试验,杂志文章
doi:10.1007/s12028-014-0004-x
更新日期:2014-10-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-019-00881-7
更新日期:2020-08-01 00:00:00
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journal_title:Neurocritical care
pub_type: 临床试验,杂志文章
doi:10.1385/NCC:3:1:016
更新日期:2005-01-01 00:00:00
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pub_type: 杂志文章
doi:10.1007/s12028-020-01026-x
更新日期:2020-06-18 00:00:00
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pub_type: 历史文章,杂志文章
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更新日期:2019-08-01 00:00:00
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pub_type: 杂志文章
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