Abstracts

To analyze characteristics and risk factors of seizures following ruptured aneurysmal subarachnoid hemorrhage (SAH). , We studied a total of 544 patients with acute SAH treated with clipping (444), detachable coil embolization (37), and conservative treatment (67) at Nakamura memorial hospital between 1998 and 2004. The age ranged from 26 to 92 years old (mean 60years old). We characterized seizures following SAH and compared risk factors of seizures between seizure group and non-seizure group. , Sixty-seven (12%) patients had seizures (seizure group) 58 (87%) in clipping, 7 (10%) in embolism, and 2(3%) in conservative treatment. Other 477 (88%) patients had no seizure history for 7 years follow-up (non-seizure group). Thirty (44%) of 67 patients presented seizure within 24 hours following SAH (acute onset), and 37 patients (56%) after 24 hours (late onset). Sudden generalized convulsions occurred in 27 (90%) patients in the acute onset group. Focal seizures occurred in 31 (84%) patients in the late onset group. Two (7%) patients had following epileptic seizure disorders in the acute onset group and 11 (30%) in the late onset group. Thirty-one (46%) of 67 patients in seizure group resulted in good prognosis (modified Rankin Scale0-2) and 320 (65%) of 477 patients in non-seizure group(P[lt]0.05)Seizure group showed more than three times higher rate of symptomatic hydrocephalus, 34(51%):76(16%); infarction due to vasospasm, 18(27%):41(9%); and other co-morbidities, 34(51%):48(10%); compared with those of non-seizure group (p[lt]0.05). , Seizure group revealed worse prognosis and more correlated with hydrocephalus, vasospasms and co-morbidities than non-seizure group. Seizures following SAH characterized generalized convulsions at acute onset, and focal seizures at late onset. The late onset seizure group tended to develop epileptic seizure disorders compared with acute onset seizure group.,