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Incidence and predictors of late seizures in intracerebral hemorrhages

Costanza Rossi1, Veerle De Herdt, Nelly Dequatre-Ponchelle

  • 1Neurology Department, Université Lille Nord de France, Lille, CHU Lille, EA 1046, Lille, France 59000.

Stroke
|May 4, 2013
PubMed

Insights

Late seizures after intracerebral hemorrhage are common, occurring months later. Cortical involvement and brain microbleeds predict these seizures, suggesting underlying vascular issues.

Area of Science:

  • Neurology
  • Stroke Research
  • Neurosurgery

Background:

  • Intracerebral hemorrhage (ICH) can lead to delayed neurological complications.
  • Late seizures (LS), occurring more than a week after stroke, require further investigation.
  • Understanding predictors of LS is crucial for patient management and prognosis.

Purpose of the Study:

  • To determine the incidence of late seizures (LS) following intracerebral hemorrhage (ICH).
  • To identify predictors of LS in a prospective cohort of ICH patients.
  • To explore the association between MRI biomarkers and LS risk.

Main Methods:

  • Prospective cohort study of 325 adult patients with spontaneous ICH.
  • Cox regression analysis used to identify incidence and predictors of LS.
  • Multivariate analyses incorporated MRI biomarkers including cortical atrophy, leukoaraiosis, and brain microbleeds.

Main Results:

  • The incidence rate of LS was 4 per 100 person-years, with a median delay of 9 months post-ICH.
  • Cortical involvement of the ICH was the sole independent predictor of LS (HR 2.8).
  • Lobar brain microbleeds, particularly ≥3, were associated with increased LS risk (HR 2.4-2.7).
  • LS were linked to poorer functional outcomes at 3-year follow-up.

Conclusions:

  • Late seizures occur frequently after ICH, necessitating long-term patient monitoring.
  • The association of lobar microbleeds with LS suggests a potential link to cerebral amyloid angiopathy.
  • Identifying high-risk patients through imaging biomarkers can inform clinical follow-up strategies.
Abstract

Keywords:
cerebral amyloid angiopathyintracerebral hemorrhageseizuresstroke

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