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Incidence and predictors of late seizures in intracerebral hemorrhages.

AbstractBACKGROUND AND PURPOSE:
To identify incidence and predictors of late seizures (LS, occurring >1 week of stroke) in a cohort of patients with intracerebral hemorrhage (ICH).
METHODS:
Prospective cohort of consecutive adults with spontaneous ICH. Incidence and predictors were identified with Cox regression. We included multivariate analyses on MRI biomarkers (global cortical atrophy, leukoaraiosis, brain microbleeds).
RESULTS:
Our study population consisted of 325 patients: 54% men, median age 70 years (interquartile range, 58-79). During 778 person-years of follow-up, the incidence rate was 4 new cases/100 person-years (95% confidence interval, 3-6). The median delay between ICH and LS was 9 months (interquartile range, 3-23). The only factor independently associated with the occurrence of LS was a cortical involvement of the ICH (hazard ratio, 2.8; 95% confidence interval, 1.3-6.1). Concerning MRI biomarkers, multivariate analyses found lobar brain microbleeds to be associated with LS (hazard ratio, 2.4; 95% confidence interval, 1.1-5.4), especially if ≥ 3 (hazard ratio, 2.7; 95% confidence interval, 1.1-6.8). LS were associated with a worse functional outcome after 3 years of follow-up (P=0.009).
CONCLUSIONS:
LS frequently occur >9 months after ICH onset, imposing a long-term follow-up. The association of lobar brain microbleeds with the risk of LS might suggest a link with the underlying vasculopathy (cerebral amyloid angiopathy).
AuthorsCostanza Rossi, Veerle De Herdt, Nelly Dequatre-Ponchelle, Hilde Hénon, Didier Leys, Charlotte Cordonnier
JournalStroke; a journal of cerebral circulation (Stroke) Vol. 44 Issue 6 Pg. 1723-5 (Jun 2013) ISSN: 1524-4628 [Electronic] United States
PMID23640832 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Topics
  • Aged
  • Cerebral Amyloid Angiopathy (complications)
  • Cerebral Hemorrhage (epidemiology, mortality, pathology)
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Hemorrhage (complications)
  • Humans
  • Incidence
  • Kaplan-Meier Estimate
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Prospective Studies
  • Risk Factors
  • Seizures
  • Survival Rate
  • Time Factors

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