Association of Seizure in Functional Outcome of Spontaneous Intracerebral Haemorrhage
DOI:
https://doi.org/10.52783/jns.v14.2489Keywords:
Spontaneous intracerebral hemorrhage (sICH), seizure, outcome, risk factors, modified rankin scale (mRS)Abstract
Background: Spontaneous intracerebral hemorrhage (sICH) is a severe and life-threatening condition, characterized by bigh mortality and morbidity rates. Seizures often complicate the acute phase of sICH, and understanding the impact of seizures on outcomes is limited. Appropriate addressing seizures in sICH improve functional outcomes.
Objectives of the study: To see association of seizure in functional outcome of spontaneous intracerebral haemorrhage.
Materials and Methods: A prospective longitudinal study was conducted at the Stroke Clinic, Stroke Centre, Indoor, EEG Lab of the Department of Neurology and Indoor, Emergency of the Department of Neurosurgery at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. The study included 66 patients with spontaneous intracerebral hemorrhage (sICH) aged 18 years or older who were consecutively recruited during the study period. Data was analyzed using SPSS version 21, with statistical tests including chi-square and t-tests as appropriate.
Result: The study result reveals that slCH with seizure associated with poor outcome. Disorientation (15.6% vs. 93.8%, p<0.001), hyponatremia (15.6% vs. 37.5%, p <0.048), pneumonia (25.0% vs. 6.3%, p=0.039) were more common in patients of sICH with seizure than witout seizure and has impact on functional outcome. According to a multivariate logistic regression analysis, seizures, disorientation, hypertension, high NIHSS score, hyponatremia, and intraventricular extension were significant predictors of poor outcome in patients with spontaneous intracerebral hemorrhage with seizure.
Conclusion: Patients of spontaneous intracerebral hemorrhage with seizures exhibited more severe neurological impairments and poorer outcomes compared to those without seizures.
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Tran QK, Bzhilyanskaya V, Afridi LZ, Ahmad M, Palmer J, Rehan MA, Raffman A, Rashid A, Menne A, Pourmand A. Preventing seizure occurrence following spontaneous intracerebral haemorrhage: a systematic review and meta-analysis of seizure prophylaxis. Seizure. 2021 Apr 1;87:46-55.
Procaccianti, G., Zaniboni, A., Rondelli, F., Crisci, M. and Sacquegna, T., 2012. Seizures in acute stroke: incidence, risk factors and prognosis. Neuroepidemiology, 19(1), pp.45-50.
Mullen MT. Kasner SE, Messé SR. Seizures do not increase in-hospital mortality after intracerebral hemorrhage in the nationwide inpatient sample. Neurocritical care. 2013 Aug, 19:19-24.
Johnston KC, Wagner DP, Haley Jr EC, Connors Jr AF. Combined clinical and imaging information as an early stroke outcome measure. Stroke. 2002 Feb 1;33(2):466-72.
Bull FC, Al-Ansari SS, Biddle S, Borodulin K. Buman MP, Cardon G, Carty C, Chaput JP, Chastin S. Chou R, Dempsey PC. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. British journal of sports medicine. 2020 Dec 1:54(24):1451-62.
Johnson W. Onuma O, Owolabi M, Sachdev S. Stroke: a global response is needed. Bulletin of the World Health Organization. 2016 Sep 9,94(9):634.
Islam MN, Moniruzzaman M, Khalil MI, Basri R, Alam MK, Loo KW, Gan SH. Burden of stroke in Bangladesh. International journal of stroke. 2013 Apr,8(3):211-3.
Amarenco P, Lavallée PC, Labreuche J. Ducrooq G, Juliard JM, Feldman L., Cabrejo L, Meseguer E, Guidoux C, Adraï V, Ratani S. Coronary artery disease and risk of major vascular events after cerebral infarction. Stroke. 2013 Jun;44(6):1505-11.
Poon MT, Fonville AF, Salman RA. Long-term prognosis after intracerebral haemorrhage: systematic review and meta-analysis. Journal of Neurology, Neurosurgery & Psychiatry. 2014 Jun 1;85(6):660-7.
Beghi E, D'alessandro R, Beretta S, Consoli D, Crespi V, Delaj L, Gandolfo C, Greco G, La Neve A, Manfredi M, Mattana F. Incidence and predictors of acute symptomatic seizures after stroke. Neurology. 2011 Nov 15;77(20):1785-93.
Bladin CF, Alexandrov AV, Bellavance A, Bornstein N, Chambers B, Coté R, Lebrun L, Pirisi A, Norris JW, Seizures After Stroke Study Group. Seizures after stroke: a prospective multicenter study. Archives of neurology. 2000 Nov 1;57(11):1617-22.
Woo KM, Yang SY, Che KT. Seizures after spontaneous intracerebral hemorrhage. Journal of Korean Neuronergical Society. 2012 Oct;52(4):312.
Claassen J, Jette N. Chum F, Green R. Schmidt M, Choi H, Jirsch 1, Frontera JA, Connolly ES, Emerson RG, Mayer SA. Electrographic seizures and periodic discharges after intracerebral hemorrhage. Neurology 2007 Sep 25:69(13):1356-65.
Bladin CF, Alexandrov AV, Bellavance A, Bornstein N, Chambers B, Coté R, Lebrun L, Pirisi A, Norris JW, Seizures After Stroke Study Group. Seizures after stroke: a prospective multicenter study. Archives of neurology. 2000 Nov 1;57(11):1617-22.
Biffi A, Rattani A, Anderson CD, Ayres AM, Gurol EM, Greenberg SM, Rosand J, Viswanathan A Delayed seizures after intracerebral haemorrhage. Brain. 2016 Oct 1:139(10):2694-70514.
Haapaniemi E, Strbian D, Rossi C, Putaala J. Sipi T, Mustanoja S, Sairanen T, Curtze S, Satopää 3, Roivainen R, Kaste M. The CAVE score for predicting late seizures after intracerebral hemorrhage. Stroke. 2014 Jul;45(7):1971-6.
Cervoni L, Artico M, Salvati M, Bristot R, Franco C, Delfini R. Epileptic seizures in intracerebral hemorrhage: a clinical and prognostic study of 55 cases. Neurosurgical review. 1994 Sep;17:185-8.
Kase CS. Intracerebral hemorrhage: non-hypertensive causes. Stroke. 1986 Jul;17(4):590-5.
Portenoy RK, Lipton RB, Berger AR, Lesser ML, Lantos G. Intracerebral haemorrhage: a model for the prediction of outcome. Journal of Neurology, Neurosurgery & Psychiatry. 1987 Aug 1;50(8):976-9.
:20 AM, 3/17/2025] Aparna: 19. Szaflarski JP, Rackley AY, Kleindorfer DO, Khoury 1, Woo D. Miller R, Alwell K. Broderick JP, Kissels BM. Incidence of seizures in the acute phase of stroke: a population-based study. Epilepsia. 200% Jan:49(6): 974-81.
Tran QK, Bzhilyanskaya V, Afridi LZ, Ahmad M, Palmer J, Rehan MA, Raffman A, Rashid A, Menne A, Pourmand A. Preventing seizure occurrence following spontaneous intracerebral haemorrhage: a systematic review and meta-analysis of seizure prophylaxis. Seizure. 2021 Apr 1;87:46-55.
Mullen MT, Kasner SE, Messé SR. Seizures do not increase in-hospital mortality after intracerebral hemorrhage in the nationwide inpatient sample. Neurocritical care. 2013 Aug;19:19-24.
Hussain MA, Alali AS, Mamdani M, Tu JV, Saposnik G, Salata K, Nathens AB, de Mestral C, Bhatt DL, Verma S, Al-Omran M. Risk of intracranial hemorrhage after carotid artery stenting versus endarterectomy: a population-based study. Journal of Neurosurgery. 2018 Feb 2;129(6):1522-9.
Baker TS, Kellner CP, Colbourne F, Rincon F, Kolimar R, Badjatia N, Dangayach N, Mocco J, Selim MH, Lyden P. Polderman K. Consensus recommendations on therapeutic hypothermia after minimally invasive intracerebral hemorrhage evacuation from the hypothermia for intracerebral hemorrhage (HICH) working group. Frontiers in neurology. 2022 Aug 17:13:859894.
Dos Reis Zuniga RD, Vieira RD, Solla DJ, Godoy DA, Kolias A, de Amorim RI, de Andrade AF. Teixeira MJ, Paiva WS. Long-term outcome of traumatic brain injury patients with initial GCS of 3-5. World Neurosurgery: X. 2024 Jul 1:23:100361.
Zandieh, A., Messé, S.R., Cucchiara, B., Mullen, M.T., Kasner, S.E. and VISTA-ICH Collaborators, 2016. Prophylactic use of antiepileptic drugs in patients with spontaneous intracerebral hemorrhage. Journal of Stroke and Cerebrovascular Diseases, 25(9), pp.2159-2166.
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