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Seizure and status epilepticus in chronic subdural hematoma.

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Title: Seizure and status epilepticus in chronic subdural hematoma.
Authors: Won, Sae‐Yeon (AUTHOR), Dubinski, Daniel (AUTHOR), Sautter, Lisa (AUTHOR), Hattingen, Elke (AUTHOR), Seifert, Volker (AUTHOR), Rosenow, Felix (AUTHOR), Freiman, Thomas (AUTHOR), Strzelczyk, Adam (AUTHOR), Konczalla, Juergen (AUTHOR)
Source: Acta Neurologica Scandinavica. Sep2019, Vol. 140 Issue 3, p194-203. 10p.
Subjects: Subdural hematoma, Status epilepticus, Hospital admission & discharge, Glasgow Coma Scale, Seizures (Medicine), Disease incidence
Abstract: Background: Acute symptomatic seizure (ASz) and status epilepticus (SE) are serious conditions associated with poor quality of life, with unfavorable psychosocial and functional outcome. Chronic subdural hematoma (cSDH) is a common neurosurgical disease related to those complications; therefore, we aimed to evaluate incidence, predictors of ASz/SE, and outcome in this cohort. Methods: We retrospectively analyzed patient diagnosed cSDH between 2010 and 2017. Beside their incidence of ASz/SE, patient characteristics, symptoms at admission, comorbidities, and all previously published relevant parameters were assessed. Recurrence rate and functional outcome were analyzed at hospital discharge and 90‐day follow‐up. Results: A total of 375 patients were included; incidence of ASz was 15.2% and of SE, 1.9%. In the univariate analysis, drainage insertion (P =  0.004; OR = 0.3) was a significant negative predictor for ASz/SE and multivariate analysis, including all significant parameters, designated GCS ≤13 at admission (P = 0.09; OR = 1.9), remote stroke (P = 0.009; OR = 2.9), and recurrence rate within 14 days (P = 0.001; OR = 3.3; with an incidence of 13%) as independent predictors for ASz/SE. Overall, patients with ASz/SE had significantly unfavorable outcome at discharge (54.7%; P < 0.001) and follow‐up (39.5%; P < 0.001) with only slight improvement. Late seizures occurred in 3.8% within follow‐up period. Any patient with SE had an unfavorable outcome at discharge without any improvement at follow‐up having a mortality rate of 14.2%. Conclusion: Independent predictors for ASz/SE are GCS ≤13 at admission, remote stroke, and recurrent hematoma in patients with cSDH, which is associated with worse functional outcome, particularly those with SE. Due to the higher rate of seizures than recurrence rate, a routine pre‐ and postoperative EEG besides CT is recommended. [ABSTRACT FROM AUTHOR]
Copyright of Acta Neurologica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Group: Ti
  Data: Seizure and status epilepticus in chronic subdural hematoma.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Won%2C+Sae‐Yeon%22&quot;&gt;Won, Sae‐Yeon&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Dubinski%2C+Daniel%22&quot;&gt;Dubinski, Daniel&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Sautter%2C+Lisa%22&quot;&gt;Sautter, Lisa&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Hattingen%2C+Elke%22&quot;&gt;Hattingen, Elke&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Seifert%2C+Volker%22&quot;&gt;Seifert, Volker&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Rosenow%2C+Felix%22&quot;&gt;Rosenow, Felix&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Freiman%2C+Thomas%22&quot;&gt;Freiman, Thomas&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Strzelczyk%2C+Adam%22&quot;&gt;Strzelczyk, Adam&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Konczalla%2C+Juergen%22&quot;&gt;Konczalla, Juergen&lt;/searchLink&gt; (AUTHOR)
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Acta+Neurologica+Scandinavica%22&quot;&gt;Acta Neurologica Scandinavica&lt;/searchLink&gt;. Sep2019, Vol. 140 Issue 3, p194-203. 10p.
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  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Subdural+hematoma%22&quot;&gt;Subdural hematoma&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Status+epilepticus%22&quot;&gt;Status epilepticus&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Hospital+admission+%26+discharge%22&quot;&gt;Hospital admission &amp; discharge&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Glasgow+Coma+Scale%22&quot;&gt;Glasgow Coma Scale&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Seizures+%28Medicine%29%22&quot;&gt;Seizures (Medicine)&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Disease+incidence%22&quot;&gt;Disease incidence&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Acute symptomatic seizure (ASz) and status epilepticus (SE) are serious conditions associated with poor quality of life, with unfavorable psychosocial and functional outcome. Chronic subdural hematoma (cSDH) is a common neurosurgical disease related to those complications; therefore, we aimed to evaluate incidence, predictors of ASz/SE, and outcome in this cohort. Methods: We retrospectively analyzed patient diagnosed cSDH between 2010 and 2017. Beside their incidence of ASz/SE, patient characteristics, symptoms at admission, comorbidities, and all previously published relevant parameters were assessed. Recurrence rate and functional outcome were analyzed at hospital discharge and 90‐day follow‐up. Results: A total of 375 patients were included; incidence of ASz was 15.2% and of SE, 1.9%. In the univariate analysis, drainage insertion (P&#160;=&#160; 0.004; OR&#160;=&#160;0.3) was a significant negative predictor for ASz/SE and multivariate analysis, including all significant parameters, designated GCS ≤13 at admission (P&#160;=&#160;0.09; OR&#160;=&#160;1.9), remote stroke (P&#160;=&#160;0.009; OR&#160;=&#160;2.9), and recurrence rate within 14&#160;days (P&#160;=&#160;0.001; OR&#160;=&#160;3.3; with an incidence of 13%) as independent predictors for ASz/SE. Overall, patients with ASz/SE had significantly unfavorable outcome at discharge (54.7%; P&#160;&lt;&#160;0.001) and follow‐up (39.5%; P&#160;&lt;&#160;0.001) with only slight improvement. Late seizures occurred in 3.8% within follow‐up period. Any patient with SE had an unfavorable outcome at discharge without any improvement at follow‐up having a mortality rate of 14.2%. Conclusion: Independent predictors for ASz/SE are GCS ≤13 at admission, remote stroke, and recurrent hematoma in patients with cSDH, which is associated with worse functional outcome, particularly those with SE. Due to the higher rate of seizures than recurrence rate, a routine pre‐ and postoperative EEG besides CT is recommended. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: &lt;i&gt;Copyright of Acta Neurologica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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      – Type: doi
        Value: 10.1111/ane.13131
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      – Code: eng
        Text: English
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      – SubjectFull: Subdural hematoma
        Type: general
      – SubjectFull: Status epilepticus
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      – SubjectFull: Hospital admission & discharge
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      – SubjectFull: Disease incidence
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      – TitleFull: Seizure and status epilepticus in chronic subdural hematoma.
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              M: 09
              Text: Sep2019
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