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Epilepsy-associated long-term mortality after aneurysmal subarachnoid hemorrhage
Jukka Huttunen1, Antti Lindgren2, Mitja I Kurki2
1From Neurosurgery (J.H., A.L., M.I.K., T.H., J.F., T.K., M.v.u.z.F., A.I., J.E.J.) and Neurology (R.K.), KUH NeuroCenter, Kuopio University Hospital, and Faculty of Health Sciences, School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio. jukka.huttunen@kuh.fi.
Epilepsy significantly increases long-term mortality risk in subarachnoid hemorrhage survivors. Early identification and treatment of epilepsy are crucial for preventing deaths in these patients.
Area of Science:
- Neurology
- Neurosurgery
- Public Health
Background:
- Subarachnoid hemorrhage from saccular intracranial aneurysm (SIA-SAH) survivors face long-term mortality risks.
- Epilepsy is a known complication following SIA-SAH.
Purpose of the Study:
- To determine the impact of epilepsy on long-term mortality in SIA-SAH survivors.
- To investigate epilepsy as a cause of death after SIA-SAH.
Main Methods:
- A cohort of 779 12-month SIA-SAH survivors was identified from the Kuopio SIA Database.
- Finnish national registries were used to track antiepileptic drug use and causes of death (ICD-10) from 1994 to 2014.
- Median follow-up was 12.0 years, with 197 deaths recorded.
Main Results:
- Epilepsy was diagnosed in 15% (121/779) of 12-month SIA-SAH survivors.
- Epilepsy was the immediate cause of death in 21% (7/34) of epilepsy patients who died.
- Epilepsy independently increased mortality risk (HR 1.8, 95% CI 1.1-3.0).
Conclusions:
- Comorbid epilepsy significantly elevates long-term mortality risk in SIA-SAH survivors.
- Long-term follow-up for SIA-SAH survivors is essential.
- Effective management of epilepsy in SIA-SAH survivors can prevent avoidable deaths.
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