Risk factors for seizures after intracerebral hemorrhage: Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) Study

Kwon, Soo Young; Obeidat, Ahmed Z.; Sekar, Padmini; Moomaw, Charles J.; Osborne, Jennifer; Testai, Fernando D.; Koch, Sebastian; Lowe, Merredith R.; Demel, Stacie L; Coleman, Elisheva; Flaherty, Matthew L.; Woo, Daniel

doi:10.1016/j.clineuro.2020.105731

Cited by 17 publications

(33 citation statements)

References 34 publications

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“…If a stroke occurs then there might be various causes of neuronal damage (Reddy et al, 2017), leading to the occurrence of early seizures after stroke. The importance of cortical injury in seizures after F I G U R E 7 Stroke subtype and ES: Subgroup analysis by region stroke has been emphasized (Kwon et al, 2020). The possible mechanism involves increase in glutamate concentration of the extracellular excitatory neurotransmitter, resulting in excitotoxicity of glutamate.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for early–onset seizures after stroke: A systematicreview and meta‐analysis of 18 observational studies

Fan

Zhao

et al. 2021

Brain and Behavior

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Section: Discussionmentioning

confidence: 99%

Risk factors for early–onset seizures after stroke: A systematicreview and meta‐analysis of 18 observational studies

Fan

Zhao

et al. 2021

Brain and Behavior

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“…However, it only applies to hemorrhagic strokes, which limits its use. In 2020, Kwon et al [26] analyzed data from 2507 subjects from the Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) prospective study to validate the prognostic value of the CAVE score. They found that the CAVE score was significantly associated with the development of late seizures (odds ratio (OR) = 2.5, 95% confidence interval (CI) 2.0-3.2; p < 0.0001).…”

Section: Prognostic Models Based On Combinations Of the Above Predictorsmentioning

confidence: 99%

Multifactorial Predictors of Late Epileptic Seizures Related to Stroke: Evaluation of the Current Possibilities of Stratification Based on Existing Prognostic Models—A Comprehensive Review

Wiśniewski

Jatužis

2021

IJERPH

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Background: Epilepsy associated with strokes is a significant clinical and public health problem and has a negative impact on prognosis and clinical outcome. A late epileptic seizure occurring seven days after stroke is actually equated with poststroke epilepsy due to the high risk of recurrence. Predictive models evaluated in the acute phase of stroke would allow for the stratification and early selection of patients at higher risk of developing late seizures. Methods: The most relevant papers in this field were reviewed to establish multifactorial predictors of late seizures and attempt to standardize and unify them into a common prognostic model. Results: Clinical and radiological factors have become the most valuable and reproducible predictors in many reports, while data on electroencephalographic, genetic, and blood biomarkers were limited. The existing prognostic models, CAVE and SeLECT, based on relevant, readily available, and routinely assessed predictors, should be validated and improved in multicenter studies for widespread use in stroke units. Conclusions: Due to contradictory reports, a common and reliable model covering all factors is currently not available. Further research might refine forecasting models by incorporating advanced radiological neuroimaging or quantitative electroencephalographic analysis.

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“…In our analysis of the patients with MIS, the risk of developing late seizures after ICH is increased with cortical involvement and higher NIHSS scores. Cortical involvement has been consistently reported as a risk factor for post-ICH seizures (14,15,17,26). Gliosis, neuronal loss, hemosiderin deposition, neurodegeneration and altered synaptic plasticity in neurons near the cortical area lead to greater hyperexcitability of synaptic activities than that in the deep part of the brain parenchyma (30).…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, several trials have shown that craniotomy does not improve the functional outcome or mortality of ICH, likely because the surgical approach creates sufficient trauma to the surrounding brain for hematoma evacuation ( 5 , 6 ). Previous studies have explored the relationship between conventional surgical hematoma evacuation and late seizures ( 15 , 17 ). A prospective study of spontaneous intracerebral hemorrhage found that conventional surgical hematoma evacuation was an independent risk factor for late seizures (OR = 2.6; 95% CI = 1.4–4.8; p value = 0.0027) ( 15 ).…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have shown several risk factors for late seizures after ICH, such as cortical involvement, early seizures, a larger hemorrhage volume, a younger age of ICH onset, conventional surgical interventions, intraventricular hemorrhage, and the NIHSS score (10,(14)(15)(16)(17)(18). However, the association between minimally invasive hematoma aspiration and thrombolysis and late seizures after ICH remains uncertain.…”

Section: Introductionmentioning

confidence: 99%

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Association between minimally invasive surgery and late seizures in patients with intracerebral hemorrhage: A propensity score matching study

Lin

et al. 2022

Front. Surg.

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PurposeThe association between minimally invasive surgery (MIS) for hematoma evacuation and late seizures after intracerebral hemorrhage (ICH) remains uncertain. We aimed to investigate whether MIS increases the risk of late seizures after ICH and identify the risk factors for late seizures in this patient subgroup.MethodsWe retrospectively included consecutive inpatients diagnosed with ICH at two tertiary hospitals in China. The subjects were divided into the MIS group (ICH patients who received MIS including hematoma aspiration and thrombolysis) and conservative treatment group (ICH patients who received conservative medication). Propensity score matching was performed to balance possible risk factors for late seizures between the MIS and conservative treatment groups. Before and after matching, between-group comparisons of the incidence of late seizures were performed between the MIS and conservative treatment groups. Univariate and multivariate logistic regression analyses were used to identify independent risk factors for late seizures in MIS-treated patients.ResultsA total of 241 and 1,689 patients were eligible for the MIS and conservative treatment groups, respectively. After matching, 161 ICH patients from the MIS group were successfully matched with 161 ICH patients from the conservative treatment group (1:1). Significant differences (p < 0.001) were found between the MIS group (31/241, 12.9%) and conservative treatment group (69/1689, 4.1%) in the incidence of late seizures before matching. However, after matching, no significant differences (p = 0.854) were found between the MIS group (17/161, 10.6%) and conservative treatment group (16/161, 9.9%). Multivariate logistic regression analysis revealed that cortical involvement (OR = 2.547; 95% CI = 1.137–5.705; p value = 0.023) and higher National Institutes of Health Stroke Scale (NIHSS) scores (OR = 1.050; 95% CI = 1.008–1.094; p value = 0.019) were independent risk factors for late seizures.ConclusionOur study revealed that receiving MIS did not increase the incidence of late seizures after ICH. Additionally, cortical involvement and NIHSS scores were independent risk factors for late seizures in MIS-treated patients.

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Risk factors for seizures after intracerebral hemorrhage: Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) Study

Cited by 17 publications

References 34 publications

Risk factors for early–onset seizures after stroke: A systematicreview and meta‐analysis of 18 observational studies

Risk factors for early–onset seizures after stroke: A systematicreview and meta‐analysis of 18 observational studies

Multifactorial Predictors of Late Epileptic Seizures Related to Stroke: Evaluation of the Current Possibilities of Stratification Based on Existing Prognostic Models—A Comprehensive Review

Association between minimally invasive surgery and late seizures in patients with intracerebral hemorrhage: A propensity score matching study

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