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Seizures after decompressive hemicraniectomy for ischaemic stroke

C J Creutzfeldt1, D L Tirschwell1, L J Kim1

  • 1Department of Neurology and Neurosurgery, University of Washington, Seattle, Washington, USA.

Journal of Neurology, Neurosurgery, and Psychiatry
|August 7, 2013
PubMed
Abstract

Insights

Patients undergoing decompressive hemicraniectomy for malignant middle cerebral artery infarction face a high risk of seizures, particularly after cranioplasty. Further research is needed to mitigate this complication.

Area of Science:

  • Neurology
  • Neurosurgery
  • Stroke Medicine

Background:

  • Malignant middle cerebral artery (MCA) infarction is a severe condition often requiring decompressive hemicraniectomy (DHC).
  • The risk of post-stroke seizures and their impact on recovery after DHC for MCA infarction remain unclear.

Purpose of the Study:

  • To investigate the incidence of seizures following DHC for malignant MCA infarction.
  • To assess the influence of seizures on the recovery and quality of life in stroke survivors.

Main Methods:

  • Retrospective review of medical charts for patients with space-occupying MCA ischemic stroke who underwent DHC.
  • Follow-up interviews with survivors and their surrogates to gather data on seizures and functional outcomes.

Main Results:

  • 49% of patients (27/55) experienced seizures, and 45% (25/55) developed epilepsy.
  • Male gender was the only significant predictor of seizure occurrence.
  • Seizures often occurred weeks after cranioplasty, and longer follow-up was observed in patients with seizures.

Conclusions:

  • High risk of seizures exists after DHC for malignant MCA stroke, with a notable incidence post-cranioplasty.
  • Strategies to reduce seizure occurrence in this patient population should be explored.
Keywords:
NeurosurgeryRehabilitationStroke

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