Post-operative seizures after burr hole evacuation of chronic subdural hematomas: is prophylactic anti-epileptic medication needed?

Flores, Gabriel; Vicenty, Juan C; Pastrana, Emil A.

doi:10.1007/s00701-017-3298-6

Cited by 20 publications

(11 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our study the mean age of two Groups 61.6 years with age ranges from 30 to 84 years. Similar to Flores et al [12], the mean age was 59 years (range: 18 -98 years), and Huang et al [13] mean age was 69.0 years and rang from (29 -90 years). In our study in two Groups male equal to female and both of them were 13 patients in contrast to other studies in which male more than female.…”

Section: Discussionsupporting

confidence: 71%

“…The incidence of seizures in Flores et al [12] was low 2.3% in spite he didn't give prophylactic antiepileptic in patients of chronic subdural hematoma treated by burr hole evacuation. He decided not to give prophylactic antiepileptic due to their side effect and the risk to develop seizures very low.…”

Section: Discussionmentioning

confidence: 94%

“…In our study in two Groups male equal to female and both of them were 13 patients in contrast to other studies in which male more than female. [12] [13] there is a history of head trauma in 30.8% of the patients. In contrast to other study in which 72% of patients had history of head trauma [13], the reason of that may be due to the minor trauma may pass without observation.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Anticonvulsants for Preventing Seizures in Patients with Chronic Subdural Haematoma: Pilot Study

Ghoneim¹,

Abbass²

2020

OJMN

View full text Add to dashboard Cite

Introduction: There is increasing of the incidence of chronic subdural hematomas (CSDH), due to increase of the elderly population with increase of intake oral anticoagulation and antiplatelet drugs in this category of patients. Seizures occur as a complication in 2.3% to 20.4% of the patients. There is a considerable side effect associated with using of anti-epileptic drugs (AEDs). Aim of the Study: To rule the value of prophylactic antiepileptic drugs in prevention of seizures after surgical evacuation of chronic subdural hematoma. Methods: A prospective controlled non-randomized study was performed on 26 patients with chronic or subacute subdural hematoma that was surgically evacuated through burr-holes from April 2017 to June 2019. We divided the patients into 2 groups: group A patients received prophylactic antiepileptic drugs for 6 month and group B patients didn't receive prophylactic antiepileptic drugs and the 2 groups were observed to detect occurrence of post-operative seizures for 6-month follow-up after surgery. Medical history, demographic data and imaging characteristics were recorded. Results: Seizure prevalence for all patients during hospitalization and 6-month follow-up was zero among the 13 patients who received prophylactic anti-seizure medications, and was 1 (7.7%) among the 13 patients who didn't receive prophylactic anti-seizure medications. Conclusions: The incidence of post-operative seizures in patients with chronic subdural hematoma operated upon by burr holes evacuation is low. The administration of prophylactic antiepileptic drugs decreases the incidence of seizures after evacuation of CSDH, but the difference was not significant. So prophylactic antiepileptic drugs should not be routinely given for all patients with CSDH operated upon by burr hole evacuation unless there is risk factor for seizure development.

show abstract

Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Anticonvulsants for Preventing Seizures in Patients with Chronic Subdural Haematoma: Pilot Study

Ghoneim¹,

Abbass²

2020

OJMN

View full text Add to dashboard Cite

show abstract

“…5 of them had cortical or intraparenchymal hematomas. Flores, G. et al, had percentage of 2.3 of their patients with postoperative seizures [20]. Chih-Wei, C. et al, reported an incidence of 5.4% of postoperative seizure in their study [21].…”

Section: Resultsmentioning

confidence: 91%

Efficacy of Single Burr Hole in Management of Chronic Subdural Hematoma

Elshanawany¹,

Abokresha²,

Mahmoud³

2020

OJMN

View full text Add to dashboard Cite

Background: Surgery of chronic subdural hematoma (CSDH) is a common practice of neurosurgeons. CSDH is considered a pathology of the elderly and usually many co-morbidities are present. CSDH carries high risk of mortality if not treated or not treated well. So, the minimal, safe and adequate surgical intervention is the bases to choose specific surgical maneuver. Aim of the Study: The efficacy of a single burr in evacuation and treatment of chronic subdural hematoma. Methods: This study was held in Assiut university hospitals, neurosurgical department. It is a prospective randomized controlled study. 113 patients were enrolled in this study in the period between March 2018 and June 2019. We included all cases of chronic subdural hematoma (CSDH) and subacute subdural hematoma that were evacuated with single burr hole. Hematomas either, unilateral or bilateral were included. Septated hematomas were excluded. Patients' clinical characteristics as age, sex, clinical presentation, co-morbidities and patients outcome were recorded. Postoperative status as regards improvement of the neurological status, complications and recurrence of hematoma were recorded. Results: We had 113 patients operated via properly situated single burr hole in our study. 113 patients were included in this study, 79 males (69.9%) and 34 females (30.1%). Age of the patients ranges between 27 years old and 90 years old. Postoperative follow up was evaluated according to Glasgow outcome score (GOS). We had 98 patients with good recovery, 4 patients with moderate disability, 6 patients with severe disability and 5 patients died. Complications were in form of 3 patients with residual hematoma, 2 patients with tension pneumocephalus, 7 patients developed postoperative seizure, 5 cases developed cortical/parenchymal hematoma and 9 cases developed hematoma recurrence. Conclusion: Single, properly situated burr hole with previously described characters is an effective treatment option in cases of CSDH. It helps adequate, effective and safe removal of the pathology with limited maneuver.

show abstract

“…Epileptic seizures are one of the major complications associated with chronic subdural hematoma (CSDH), either in the pre- or postoperative period [1]. To date, alcohol abuse, change of mental status, and density of hematoma on computed tomography (CT) have been suggested as risk factors for epileptic seizures in patients with CSDH, excluding detectable intraparenchymal lesions on neuroimaging [2].…”

Section: Introductionmentioning

confidence: 99%

A case of chronic subdural hematoma demonstrating the epileptic focus at the area with sulcal hyperintensity on fluid-attenuated inversion recovery image

Oshida

Akamatsu

Matsumoto

et al. 2019

Radiology Case Reports

View full text Add to dashboard Cite

Although the sulcal hyperintensity on fluid-attenuated inversion recovery (FLAIR) images is detected in some chronic subdural hematoma (CSDH) cases, its clinical significance remains determined. A 77-year-old man with symptomatic CSDH presented with generalized tonic-clonic seizures at 9 days after surgery. 123 I-iomazenil -single photon emission computed tomography revealed transient reduction in cortical benzodiazepine receptors binding potential at the region corresponding to that of the sulcal hyperintensity on FLAIR images. Findings of sulcal hyperintensity on FLAIR imaging under the CSDH may have a relation with the cause of epileptic seizure.

show abstract

Post-operative seizures after burr hole evacuation of chronic subdural hematomas: is prophylactic anti-epileptic medication needed?

Abstract: The incidence of post-operative seizures in patients with CSDH evacuated via burr holes was low. Prophylactic AEDs should not be routinely administered if no other risk factor for seizure exists. Demographic and clinical factors did not appear to influence post-operative seizures.

Cited by 20 publications

References 16 publications

Anticonvulsants for Preventing Seizures in Patients with Chronic Subdural Haematoma: Pilot Study

Anticonvulsants for Preventing Seizures in Patients with Chronic Subdural Haematoma: Pilot Study

Efficacy of Single Burr Hole in Management of Chronic Subdural Hematoma

A case of chronic subdural hematoma demonstrating the epileptic focus at the area with sulcal hyperintensity on fluid-attenuated inversion recovery image

Contact Info

Product

Resources

About