Early postoperative seizures after posterior fossa surgery

Area of Science:

• Neurosurgery
• Neurology
• Critical Care Medicine

Background:

• Posterior fossa operations are complex neurosurgical procedures.
• Seizures are a potential complication following neurosurgery.
• The incidence and causes of early postoperative seizures after suboccipital craniectomy require further elucidation.

Purpose of the Study:

• To determine the incidence of seizures in patients undergoing posterior fossa operations without prophylactic anticonvulsant agents.
• To identify risk factors and causes associated with early postoperative seizures.

Main Methods:

• Retrospective review of 726 patients who underwent 740 posterior fossa operations via suboccipital craniectomy.
• Analysis of seizure incidence within 2 weeks postoperatively.
• Correlation of seizure occurrence with tumor type, shunting, and metabolic disturbances.

Main Results:

• Overall seizure incidence was 1.8% (13/726) within 2 weeks postoperatively.
• Seizures within 24 hours (0.7%) were linked to metabolic acidosis and hyponatremia.
• Seizures between postoperative days 2-14 were associated with hydrocephalus and remote supratentorial hemorrhage; two cases had meningitis.

Conclusions:

• Suboccipital craniectomy for posterior fossa lesions carries a risk of early postoperative seizures.
• Metabolic derangements and post-surgical complications like hydrocephalus are significant contributors to seizure development.