Incidence, predictors, and outcome of early seizures after mechanical thrombectomy.

Abstract:

OBJECTIVE:Despite the wide utilization of mechanical thrombectomy (MT) for acute ischemic stroke treatment, little is known about the incidence of early post-thrombectomy seizures, its predictors, and association with long-term outcome. METHODS:Using a prospective registry of mechanical thrombectomy in ischemic stroke between January 2013 and July 2017, we identified patients who developed a seizure within 7 days (early seizure) of qualifying event. Backward stepwise regression analysis was used to assess independent predictors of seizure occurrence and the association between seizure and functional outcome (modified Rankin scale of 0-2 vs. ≥3). RESULTS:A total of 459 patients were included in the final analysis. Mean age was 67.5 (SD 15.1), and 49.9% of patients were female. Successful recanalization (TICI≥2B) was achieved in 92.8% of patients. Eleven (2.4%) patients developed at least one seizure. Only an Alberta Stroke Program Early CT (ASPECT) score of <6 was independently associated with the occurrence of early seizures [Odds ratio, 95% confidence interval: 8.188, (2.219-30.214); P = .002]. On multivariate analysis, early seizures were associated with 90-day mortality rate [OR,6.487; 95% confidence interval, (1.481-28.405); P = .013] and poor functional outcome (OR, 4.7; 95% confidence interval (1.08-20.83); p = .039). CONCLUSION:In the studied cohort, 2.4% of ischemic stroke patients treated with MT developed at least one seizure within 7 days of stroke onset. A low ASPECT score was associated with the occurrence of early seizures. The occurrence of seizures was associated with 90-day mortality and poor functional outcome.

journal_name

J Neurol Sci

authors

Anadani M,Lekoubou A,Almallouhi E,Alawieh A,Chatterjee A,Vargas J,Spiotta AM

doi

10.1016/j.jns.2018.11.033

subject

Has Abstract

pub_date

2019-01-15 00:00:00

pages

235-239

eissn

0022-510X

issn

1878-5883

pii

S0022-510X(18)30486-6

journal_volume

396

pub_type

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