Faculty Collaboration Database

Risk factors for seizures after intracerebral hemorrhage: Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) Study. Clin Neurol Neurosurg 2020 May;192:105731

Date

02/18/2020

Pubmed ID

32062309

Pubmed Central ID

PMC7183434

DOI

10.1016/j.clineuro.2020.105731

Scopus ID

2-s2.0-85079198313 (requires institutional sign-in at Scopus site)   15 Citations

Abstract

OBJECTIVE: We aimed to identify risk factors for seizures after intracerebral hemorrhage, and to validate the prognostic value of the previously reported CAVE score (0-4 points: cortical involvement, age <65, volume >10 mL, and early seizures within 7 days of hemorrhage).

PATIENTS AND METHODS: Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) was a prospective study of spontaneous intracerebral hemorrhage. We included patients who did not have a prior history of seizure and survived to discharge. Univariate analysis and multiple logistic regression modeling were used to identify risk factors for seizure.

RESULTS: From 2010-2015, 3000 cases were recruited, and 2507 patients were included in this study. Seizures after hospital discharge developed in 77 patients 3.1 %). Patients with lobar (cortical) hemorrhage (OR 3.0, 95 % CI 1.8-5.0), larger hematoma volume (OR 1.5 per cm³, 95 % CI 1.2-2.0), and surgical evacuation of hematoma (OR 2.6, 95 % CI 1.4-4.8) had a higher risk of late seizure, and older patients had a lower risk (OR 0.88 per 5-year interval increase, 95 % CI 0.81-0.95). The CAVE score was highly associated with seizure development (OR 2.5 per unit score increase, 95 % CI 2.0-3.2, p < 0.0001). The CAVS score, substituting surgical evacuation for early seizure, increased the OR per unit score to 2.8 (95 % CI 2.2-3.5).

CONCLUSIONS: Lobar hemorrhage, larger hematoma volume, younger age, and surgical evacuation are strongly associated with the development of seizures. We validated the CAVE score in a multi-ethnic population, and found the CAVS score to have similar predictive value while representing the current practice of AED use.

Author List

Kwon SY, Obeidat AZ, Sekar P, Moomaw CJ, Osborne J, Testai FD, Koch S, Lowe MR, Demel S, Coleman ER, Flaherty M, Woo D

Author

Ahmed Zayed Obeidat MD, PhD Associate Professor in the Neurology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Age Factors
Aged
Anticonvulsants
Cerebral Cortex
Cerebral Hemorrhage
Epilepsy
Female
Humans
Length of Stay
Logistic Models
Male
Middle Aged
Multivariate Analysis
Prognosis
Prospective Studies
Risk Assessment
Risk Factors
Seizures
Time Factors