Do Early Seizures Indicate Survival of Patients with Nontraumatic Intracerebral Hemorrhage?

Early seizures (ESs) in patients with nontraumatic spontaneous intracerebral hemorrhage (sICH) are a frequent complication. The aims of this study were to determine the frequency of ESs in patients with sICH and to investigate the association of ESs with outcomes in a monocenter study.

During a 5-year period (2009-2013), 484 consecutive patients (mean age 72.3 ± 12.6; female sex 51%) with sICH who were admitted to the Department of Neurology at the University of Lübeck, Germany were enrolled and prospectively evaluated.

A total of 52 patients (10.7%; 95% CI 8-14) experienced ESs during a mean hospitalization of 12 days. Patients with ESs were less affected on the National Institutes of Health Stroke Scale at admission than those without ESs (7 vs. 10; p = 0.02). With the exception of the localization of hemorrhage (p = 0.008), differences in the baseline characteristics between patients with ESs and those without ESs were not found. The logistic regression analysis revealed an increased ES rate in patients with cortical hemispheric sICH (OR 3.5; 95% CI 1.8-6.7; p < 0.001). During hospitalization, 109 patients (23%) died and the in-hospital mortality was lower in patients with ESs than those without (9.6 vs. 24.0%, respectively; p = 0.02). An association between ESs and good functional outcome on the modified Rankin Scale ≤ 2 was not found (p = 0.3).

ESs appear to be correlated with hemorrhage localization and associated with survival of the sICH.