Risk Factors of Seizures Associated with the Management of Ruptured Cerebral Aneurysms

Abstract

Objective : This study was designed to to analyze the associated risk factors of seizure after aneurysmal subarachnoid hemorrhage(SAH) for providing guidelines of prophylactic antiepileptic drug administration. Method : We retrospectively reviewed the programmed clinical database and radiographic findings of the patients with aneurysmal SAH who were treated from March 1996 to August 2004 and followed up for more than one year. Result : A total of 512 patients were enrolled. 20 patients (3.9%) presented with seizures. Aneurysm location and size were not associated with seizures. The incidence of seizure was significantly different in the Hunt & Hess Grade IV patients (8.6%) and V patients (23.1%). Fisher Grade IV was associated with a significantly higher risk of the seizure (12.2%). The incidence of seizure was higher in patients with hydrocephalus (6.7%), intracerebral hematoma (8.8%), and decompressive lobectomy (14.3%). Conclusion : The overall incidence of seizures was 3.9%. Risk factors of seizures were poor clinical grade (Hunt &Hess Grade IV and V), higher Fisher Grade (IV), hydrocephalus, intracerebral hematoma, and decompressive lobectomy.