[Epileptic syndrome in brain hemorrhages with blood breakthrough into the ventricular system]

Of 313 patients with cerebral hemorrhages and blood breakthrough into the ventricular system, 39 developed the epileptic syndrome. The epileptic seizures were the first symptom of the hemorrhage in 29 patients; in the rest 10 they became manifest on the 1st to 10th day of the stroke in the presence of pronounced focal neurological symptoms. The clinical manifestations of the epileptic syndrome were rather diverse: general convulsive seizures, focal seizures, and combination of the general and focal seizures in the same patients. The generalized seizures were indications of a failure of the compensatory mechanisms to cope with progressing cerebrovascular insufficiency, hypoxia, and cerebral edema. In the pathogenesis of the epileptic seizures in cerebral hemorrhages with blood breakthrough into the ventricular system an importance is attached to old cysts, a concurrent subarachnoidal hemorrhage, and dyshemic processes in the intact hemisphere following the pattern of interhemispheral depression of the cerebral blood flow. The relative infrequency of the epileptic syndrome in cerebral hemorrhage and the absence of a connection between the focal seizure and the localization of the hemorrhage focus do not allow one to judge about a topico-diagnostic significance of that syndrome in this form of the cerebrovascular pathology.