Seizures after decompressive surgery for cerebral venous thrombosis

Area of Science:

• Neurology
• Neurosurgery

Background:

• Cerebral venous thrombosis (CVT) is a rare but serious condition.
• Decompressive surgery is sometimes necessary for severe CVT.
• Seizure incidence and predictors after surgery for CVT are not well understood.

Purpose of the Study:

• To determine the incidence of seizures after decompressive surgery in severe CVT patients.
• To identify potential predictors of post-surgery seizures.
• To analyze seizure outcomes in this population.

Main Methods:

• Multicenter, consecutive cohort study.
• Included 116 patients undergoing decompressive surgery for CVT (2011-2019).
• Analyzed one-year seizure incidence and associated factors, adjusting for mortality.

Main Results:

• 22% of patients experienced seizures within one year post-surgery.
• The mortality-adjusted one-year seizure incidence was 23%.
• Aphasia at presentation was the only significant predictor of post-surgery seizures. 83% of seizures occurred despite anti-seizure medication, and 63% of patients had recurrent seizures.

Conclusions:

• A significant proportion of severe CVT patients experience seizures post-decompressive surgery.
• Aphasia is a key predictor for post-surgery seizures.
• Current anti-seizure medication strategies may be insufficient for this patient group, with high rates of recurrent seizures.