Seizures after decompressive hemicraniectomy ...
Document type :
Article dans une revue scientifique: Article original
DOI :
PMID :
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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]
Lille Neurosciences & Cognition (LilNCog) - U 1172
Kuchcinski, Gregory [Auteur]
Lille Neurosciences & Cognition (LilNCog) - U 1172
Chochoi, M. [Auteur]
Lejeune, Jean-Paul [Auteur]
Thérapies Lasers Assistées par l'Image pour l'Oncologie (ONCO-THAI) - U1189
Henon, Hilde [Auteur]
Lille Neurosciences & Cognition (LilNCog) - U 1172
Casolla, Barbara [Auteur]
Equipe Alzheimer and Tauopathies - LilNCog [U1172 Inserm]
Kyheng, Maéva [Auteur]
Cordonnier, Charlotte [Auteur]
Lille Neurosciences & Cognition (LilNCog) - U 1172
Kuchcinski, Gregory [Auteur]
Lille Neurosciences & Cognition (LilNCog) - U 1172
Chochoi, M. [Auteur]
Lejeune, Jean-Paul [Auteur]
Thérapies Lasers Assistées par l'Image pour l'Oncologie (ONCO-THAI) - U1189
Henon, Hilde [Auteur]
Lille Neurosciences & Cognition (LilNCog) - U 1172
Casolla, Barbara [Auteur]
Equipe Alzheimer and Tauopathies - LilNCog [U1172 Inserm]
Journal title :
European Journal of Neurology
Abbreviated title :
Eur J Neurol
Volume number :
28
Pages :
p. 2745-2755
Publication date :
2021-08
ISSN :
1468-1331
English keyword(s) :
hemicraniectomy
long‐
term outcome
mortality
poststroke seizures
stroke
long‐
term outcome
mortality
poststroke seizures
stroke
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
Background and purpose
Decompressive 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 ...
Show more >Background and purpose Decompressive 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. Methods We 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. Results Of 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. Conclusions The 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 >
Show more >Background and purpose Decompressive 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. Methods We 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. Results Of 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. Conclusions The 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
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
Université de Lille
CHU Lille
CHU Lille
Submission date :
2023-11-15T06:45:45Z
2024-02-21T08:33:45Z
2024-02-21T08:33:45Z