Abstract:
:OBJECTIVEDelay in diagnosis and subsequent treatment of nonconvulsive seizures can lead to worsened outcomes. The gold standard in detecting nonconvulsive seizures is continuous video-electroencephalography (cEEG). Compared to routine, 30-minute EEG, the use of cEEG increases the likelihood of capturing intermittent nonconvulsive seizures. Studies of critically ill patients in intensive care units demonstrate a particularly high rate of nonconvulsive seizures. Some of these studies included postneurosurgical patients, but often subanalyses of specific populations were not done. In particular, few studies have specifically evaluated postneurosurgical patients by using cEEG in the acute postoperative setting. Therefore, the incidence and predictors of acute postneurosurgical seizures are unclear.METHODSIn this study, the authors focused on patients who were admitted to the neurological critical care unit following neurosurgery and who underwent cEEG monitoring within 72 hours of surgery.RESULTSA total of 105 cEEG studies were performed in 102 patients. Twenty-nine patients demonstrated electrographic (subclinical) seizures, of whom 10 had clinical seizures clearly documented either before or during cEEG monitoring. Twenty-two patients had subclinical seizures only detected on cEEG, 19 of whom did not have clinical seizure activity at any point during hospitalization. Those with seizures were more likely to have had a history of epilepsy (p = 0.006). The EEG studies of patients with seizures were more likely to show lateralized periodic discharges (p = 0.012) and lateralized rhythmic delta activity (p = 0.012). The underlying neuropathological disorders most associated with seizure risk were lobar tumor on presentation (p = 0.048), subdural hematoma (SDH) requiring craniotomy for evacuation (p = 0.002), subarachnoid hemorrhage (SAH) (p = 0.026), and perioperative SAH (p = 0.019). In those undergoing craniotomy, the presence of SDH (p = 0.032), particularly if requiring evacuation (p = 0.003), increased the risk of seizures. In those without preoperative intracranial bleeding, perioperative SAH after craniotomy was associated with a higher incidence of seizures (p = 0.014). There was an additive effect on seizure incidence when perioperative SAH as well as concomitant intraparenchymal hemorrhage and/or stroke were present. The clinical examination of the patient, including the presence or absence of altered mental status and the presence or absence of repetitive movements, was not predictive of subclinical seizures.CONCLUSIONSIn postneurosurgical patients referred for cEEG monitoring, there is a high rate of both clinical and subclinical seizures in the early postoperative period. Seizures are particularly common in patients with SDH or lobar tumor and perioperative SAH. There was an additive effect on seizure incidence when more extensive brain injury was present. As expected, those with a history of epilepsy also demonstrated higher seizure rates. Further studies are needed to evaluate the time period of maximum seizure incidence after surgery, and the effects acute postneurosurgical seizures have on long-term outcomes.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Freund B,Probasco JC,Ritzl EKdoi
10.3171/2018.1.JNS171466subject
Has Abstractpub_date
2018-05-01 00:00:00pages
1-7eissn
0022-3085issn
1933-0693pii
2018.1.JNS171466pub_type
杂志文章abstract:OBJECT:The aim of this study was to determine the anatomical limitations of the transcallosal transchoroidal approach to the third ventricle. METHODS:Twenty-six formalin-fixed specimens were studied. Sagittal dissections were used to determine the anatomical relationships of the foramen of Monro, the angle of approach...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2008.7.JNS08124
更新日期:2009-09-01 00:00:00
abstract:OBJECTIVE:The authors aimed to determine whether differences exist in presentation and natural history when comparing Asian patients with moyamoya disease (MMD) to those of other ethnicities in North America. METHODS:A database of 137 patients with MMD presenting to their institution between 1994 and 2015 was reviewed...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2019.7.JNS191507
更新日期:2019-10-04 00:00:00
abstract::A case is reported of severe unilateral hemispheric edema and localized hemorrhage associated with seizures following endarterectomy of an ipsilateral high-grade carotid stenosis. Imaging studies including angiography, computerized tomography (CT), magnetic resonance imaging/angiography, and xenon-CT, suggested postop...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1995.83.1.0133
更新日期:1995-07-01 00:00:00
abstract:OBJECT:Medically refractory dystonia has recently been treated using deep brain stimulation (DBS) targeting the globus pallidus internus (GPI). Outcomes have varied depending on the features of the dystonia. There has been limited literature regarding outcomes for refractory dystonia following DBS of the subthalamic nu...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/JNS-07/07/0029
更新日期:2007-07-01 00:00:00
abstract::Excision is the treatment of choice in cases of sacral chordoma. Local recurrences, however, have often been observed even after total en bloc resection. The authors assessed outcomes in four cases of tumor recurrence in patients who underwent total en bloc S2-3 resection for sacral chordomas that were located below S...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2002.97.1.0098
更新日期:2002-07-01 00:00:00
abstract::Tophaceous pseudogout is one of the rarest forms of crystal deposition disease, typically presenting as a destructive and invasive mass involving the temporomandibular joint or the infratemporal fossa region in the absence of any other articular manifestations. Previous cases have been assumed to be caused by calcium ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1999.90.1.0148
更新日期:1999-01-01 00:00:00
abstract::The authors report a new case of combined atlantoaxial and occipitoatlantal rotatory subluxation in a 17-year-old girl. They describe the clinical and imaging features of this rare entity. An occiput-C2 arthrodesis was performed. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.1999.90.2.0258
更新日期:1999-04-01 00:00:00
abstract::The authors have previously advocated a supraorbital approach to tumors of the orbit. In this paper, they describe a technique in which they take advantage of a large frontal sinus as a means of entering the orbit without the necessity of intracranial exposure, as required by the more conventional supraorbital approac...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1985.63.5.0811
更新日期:1985-11-01 00:00:00
abstract::A 13-year-old girl was referred for evaluation of the deceleration in her rate of linear growth, an arrest in the progression of her pubertal maturation, and bifrontal headaches. Detailed endocrinological and radiological studies revealed the following abnormalities: partial growth hormone deficiency, prepubertal lute...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1983.58.6.0932
更新日期:1983-06-01 00:00:00
abstract:OBJECT:The goal of this study was fourfold: 1) to determine the incidence of traumatic subarachnoid hemorrhage (tSAH) in patients with traumatic brain injury (TBI); 2) to verify agreement in the diagnosis of tSAH in a multicenter study; 3) to assess the incidence of tSAH on the outcome of the patient; and 4) to establi...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.3171/jns.2003.98.1.0037
更新日期:2003-01-01 00:00:00
abstract::The second lumbar vertebra was surgically removed from 10 dogs, and the shortened vertebral column was stabilized by internal fixation with two types of plastic plates. Shortening of the spinal column was usually not associated with detectable loss of function or neurological deficit. Histological lesions, however, in...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1975.42.1.0047
更新日期:1975-01-01 00:00:00
abstract:OBJECTIVE:In daily practice, neurosurgeons face increasing numbers of patients using aspirin (acetylsalicylic acid, ASA). While many of these patients discontinue ASA 7-10 days prior to elective intracranial surgery, there are limited data to support whether or not perioperative ASA use heightens the risk of hemorrhagi...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2018.12.JNS182483
更新日期:2019-04-05 00:00:00
abstract::Primary intracerebral squamous cell carcinoma is a rare sequela of benign cerebral epidermoid cysts. A case of presumed malignant transformation in a lateral ventricular epidermoid cyst is described, in which squamous cell carcinoma arose 33 years after the surgical resection of a benign epidermoid cyst. Three years a...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1987.66.4.0618
更新日期:1987-04-01 00:00:00
abstract::Bacteriological studies were performed on 45 craniocerebral missile wounds incurred in Vietnam within 2 to 4 hours of occurrence. All missiles had penetrated into the brain. Aerobic and anaerobic cultures were taken of the skin wound, brain, and indriven bone fragments. Forty-four of the skin wounds were contaminated,...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1971.34.2part1.0145
更新日期:1971-02-01 00:00:00
abstract:OBJECT:The object of this study was to mathematically model the prognosis of a newly inserted shunt in pediatric or adult patients with hydrocephalus. METHODS:A structured search was performed of the English-language literature for case series reporting shunt failure, patient mortality, and shunt removal rates after s...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,meta分析,评审
doi:10.3171/PED-07/12/448
更新日期:2007-12-01 00:00:00
abstract::Autologous blood (0.3 to 5.0 ml) was introduced into the lumbar subarachnoid space of nine monkeys. Serial spinal cord arteriography was performed at frequent intervals over a 24-hour period. Magnification techniques permitted direct measurement of the anterior spinal artery and posterior spinal vein. Neither immediat...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1977.47.1.0064
更新日期:1977-07-01 00:00:00
abstract::Intraoperative recordings of conducted bipolar epidural somatosensory evoked potentials (SEP's) generated by unilateral common peroneal nerve stimulation have been obtained in 27 patients. The SEP's were multiphasic, 0.3 to 1.5 microV in amplitude, and recorded in 100% of patients with normal cords or in patients with...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1982.57.3.0349
更新日期:1982-09-01 00:00:00
abstract::OBJECTIVE Electrical motor cortex stimulation can relieve neuropathic pain (NP), but its use requires patients to undergo an invasive procedure. Repetitive transcranial magnetic stimulation (rTMS) of the primary motor cortex (M1) using a figure-8 coil can relieve NP noninvasively, but its ability to relieve lower limb...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,随机对照试验
doi:10.3171/2016.9.JNS16815
更新日期:2017-11-01 00:00:00
abstract:OBJECT:In an attempt to improve peripheral nerve repair, the influence of the addition of reverse end-to-side neurorrhaphy for an injured peripheral nerve was investigated in the rat sciatic nerve transection model. METHODS:Twelve Sprague-Dawley rats were divided into two groups (six rats in each group). In Group I, t...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/JNS-07/10/0821
更新日期:2007-10-01 00:00:00
abstract::The case of a myxomatous cyst of the brachial plexus is presented. The clinical course is reported, and the frequency of the lesion, diagnostic workup, histopathology, and surgical therapy are discussed. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1990.73.5.0782
更新日期:1990-11-01 00:00:00
abstract::The acquired immune deficiency syndrome (AIDS) is a recently described T-cell deficiency predisposing patients to a spectrum of opportunistic infections. Kaposi's sarcoma, and other neoplasms. It appears primarily among homosexual males and intravenous drug abusers, but is now being observed in other groups as well. T...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1983.59.6.0994
更新日期:1983-12-01 00:00:00
abstract:OBJECT:Ventricular infection after ventriculostomy placement carries a high mortality rate. Responding to ventriculostomy infection rates, a multidisciplinary performance improvement team was formed, a comprehensive protocol for ventriculostomy placement was developed, and the efficacy was evaluated. METHODS:A best-pr...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2012.11.JNS121336
更新日期:2013-03-01 00:00:00
abstract::Spontaneous intracranial hypotension due to a cerebrospinal fluid (CSF) leak in the spine is an important cause of new, daily persistent headaches. Most patients respond well to conservative treatments including epidural blood patching. Limited options for effective treatment are available for patients in whom these t...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2004.100.6.1098
更新日期:2004-06-01 00:00:00
abstract:OBJECT:The goal of this study was to quantify volumetrically cement fill and leakage in patients with osteoporotic and metastatic vertebral lesions undergoing percutaneous vertebroplasty and to establish whether these factors have any clinical significance at follow up. METHODS:Digital computerized tomography data wer...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2003.99.1.0056
更新日期:2003-07-01 00:00:00
abstract::Between 1975 and 1989, 25 children treated with myelomeningocele closure and shunting for hydrocephalus at the Children's Hospital of Pittsburgh developed progressive lower brain-stem dysfunction from their Chiari malformation. Retrospective univariate and multivariate analyses of these cases were undertaken to assess...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1992.77.6.0881
更新日期:1992-12-01 00:00:00
abstract::A unique case is reported of Chiari malformation and compression of the medulla oblongata by both vertebral arteries. A 39-year-old woman complained of unsteady giant and motor weakness of the legs, and magnetic resonance imaging revealed the malformation and compression. Vascular decompression of the vertebral arteri...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1992.77.2.0307
更新日期:1992-08-01 00:00:00
abstract::The known cytoprotective properties of MgSO4 led the authors to study its effects on infarct size in rats when administered intraarterially before reversible focal ischemia. Following an intracarotid infusion of MgSO4 in the amount of 30 mg/kg (24 animals), 90 mg/kg (18 animals), or an equal volume of vehicle (23 anim...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1996.85.1.0117
更新日期:1996-07-01 00:00:00
abstract::The authors report on the case of a 6-year-old boy who underwent resection of a midline cerebellar tumor. The boy was able to speak fluently after the operation. Magnetic resonance (MR) imaging showed that the right dentate nucleus had been partially removed along with the tumor, but that the left dentate nucleus rema...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2006.104.2.329
更新日期:2006-02-01 00:00:00
abstract::OBJECTIVE Hyperperfusion syndrome (HPS) is a notable complication that causes various neurological symptoms after superficial temporal artery (STA)-middle cerebral artery (MCA) bypass surgery for moyamoya disease (MMD). The authors used intraoperative indocyanine green (ICG) videoangiography to measure the change in m...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2016.11.JNS162403
更新日期:2018-05-01 00:00:00
abstract::Given the relatively benign natural history of cavernous carotid artery aneurysms and based on anecdotal reports in the literature of subarachnoid hemorrhage (SAH) or subdural hemorrhage (SDH) from these aneurysms, observation is warranted and typically recommended. In this case report, the authors describe a woman wh...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2006.105.2.315
更新日期:2006-08-01 00:00:00