Title :

Seizures after decompressive hemicraniectomy for large middle cerebral artery territory infarcts: incidence, associated factors and impact on long-term outcomes

Author(s) :

Masheka Cishesa, Olivier [Auteur]
Kyheng, Maéva [Auteur]
Cordonnier, Charlotte [Auteur]
Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837 [JPArc]
Kuchcinski, Gregory [Auteur]
Lille Neurosciences & Cognition - U 1172 [LilNCog]
Chochoi, M. [Auteur]
Lejeune, Jean-Paul [Auteur]
Thérapies Assistées par Lasers et Immunothérapies pour l'Oncologie - U 1189 [OncoThAI]
Henon, Hilde [Auteur]
Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837 [JPArc]
Casolla, Barbara [Auteur]
Equipe Alzheimer and Tauopathies - LilNCog [U1172 Inserm]

Journal title :

EUROPEAN JOURNAL OF NEUROLOGY

Pages :

p. 2745-2755

Publication date :

2021-08-01

ISSN :

1468-1331

English keyword(s) :

hemicraniectomy
long&#8208
term outcome
mortality
poststroke seizures
stroke

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Background and purposeDecompressive hemicraniectomy (DH) reduces mortality of large middle cerebral artery (MCA) territory infarcts. Survivors are at high risk of poststroke seizures (PSSs). This study aims to describe the ...
Show more >Background and purposeDecompressive hemicraniectomy (DH) reduces mortality of large middle cerebral artery (MCA) territory infarcts. Survivors are at high risk of poststroke seizures (PSSs). This study aims to describe the incidence of PSSs, to identify associated factors, and to assess their impact on long-term outcomes.MethodsWe included consecutive patients who underwent DH for large MCA infarcts from May 2005 to December 2019 at Lille University Hospital. Patients were followed up at 3 months, 1 year, and 3 years. We analysed (i) the incidence and associated factors of early onset PSSs (EPSSs) with logistic regression models; (ii) the incidence and associated factors of late onset PSSs (LPSSs) in survivors at 7 days with a univariate Cox proportional hazard regression model for interval-censored data; and (iii) the impact of PSSs (EPSSs and LPSSs) on mortality with univariate and multivariate Cox proportional hazard regression models and modified Rankin Scale at 1 and 3 years, with univariate and adjusted multivariate ordinal logistic regression analyses.ResultsOf 248 patients (150 men, 60.5%; mean age = 50.4 ± 9.6 years), 106 (42.7%) presented PSSs (six inaugural seizures, 22 EPSSs, 78 LPSSs) during follow-up. The PSS cumulative incidence was 12.3% at 7 days, 24.9% at 3 months, 49.8% at 1 years, and 54.8% at 3 years. No predictor was significantly associated with either EPSSs or LPSSs. PSSs did not significantly impact mortality and long-term functional outcome.ConclusionsThe incidence of PSSs after DH is high, reaching more than 50% 3 years after stroke, but PSSs did not influence long-term mortality or functional outcome.Show less >

Language :

Anglais

Popular science :

Non

Collections :

• Thérapies Lasers Assistées par l'Image pour l'Oncologie (ONCO-THAI) - U1189

Source :

Harvested from HAL