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Post-Stroke Seizures Is Associated with Low Alberta Stroke Program Early CT Score.

Ziyuan Chen1, Leonid Churilov, Miriam Koome

  • 1Melbourne Brain Centre, The Royal Melbourne Hospital, Department of Medicine, Parkville, VIC, Australia.

Cerebrovascular Diseases (Basel, Switzerland)
|March 6, 2017
PubMed
Summary

The Alberta Stroke Program Early CT Score (ASPECTS) effectively predicts post-stroke seizures. Lower ASPECTS scores and cortical involvement indicate a higher risk of seizure development after ischemic stroke.

Keywords:
Alberta Stroke Program Early CT ScoreCortical involvementIschemic lesion sizeNon-contrast CTPost-stroke seizures

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Area of Science:

  • Neurology
  • Stroke Medicine
  • Neuroimaging

Background:

  • Ischemic stroke is a primary cause of new-onset seizures.
  • Cortical ischemia and large lesion size are known risk factors for post-stroke seizures.
  • The Alberta Stroke Program Early CT Score (ASPECTS) quantifies cerebral ischemia extent.

Purpose of the Study:

  • To investigate the association between post-stroke seizures and the extent of ischemia measured by ASPECTS.
  • To determine the role of cortical involvement on non-contrast CT (NCCT) in predicting seizures.

Main Methods:

  • A prospective cohort study of acute ischemic stroke patients treated with intravenous tissue plasminogen activator.
  • Inclusion of patients with anterior circulation stroke and exclusion of those with pre-stroke seizures.
  • Analysis of NCCT scans at admission and 24 hours using logistic and Cox regression.

Main Results:

  • Out of 348 patients, 22 (6.3%) developed seizures within a median follow-up of 559 days.
  • Lower ASPECTS scores on admission and at 24 hours were significantly associated with increased seizure risk.
  • Cortical involvement at 24 hours also correlated with seizure occurrence; ASPECTS was the sole independent predictor in multivariate analysis.

Conclusions:

  • The extent of ischemia, as assessed by ASPECTS, is linked to post-stroke seizure development.
  • Cortical involvement identified on NCCT is also associated with the risk of seizures.
  • ASPECTS serves as a valuable tool for identifying patients at high risk for post-stroke seizures.