PMID- 33268192
OWN - NLM
STAT- MEDLINE
DCOM- 20210617
LR  - 20210617
IS  - 1872-6968 (Electronic)
IS  - 0303-8467 (Linking)
VI  - 200
DP  - 2021 Jan
TI  - Nonconvulsive status epilepticus after surgery for ruptured intracranial 
      aneurysms: Incidence, associated factors, and impact on the outcome.
PG  - 106298
LID - S0303-8467(20)30641-7 [pii]
LID - 10.1016/j.clineuro.2020.106298 [doi]
AB  - OBJECTIVE: To evaluate the incidence of nonconvulsive status epilepticus (NCSE) 
      after surgery for ruptured intracranial aneurysms, to define factors associated 
      with this complication, and to determine its impact on the outcome. PATIENTS AND 
      METHODS: Clinical and neurophysiological data of 66 patients with aneurysmal 
      subarachnoid hemorrhage (aSAH) who underwent continuous EEG (cEEG) monitoring 
      after microsurgical clipping (53 cases) or endovascular coiling (13 cases) of the 
      ruptured aneurysm were analyzed retrospectively. The diagnosis of NCSE was based 
      on the American Clinical Neurophysiology Society and Salzburg Consensus criteria. 
      RESULTS: NCSE was revealed in 10 patients (15 %), all of whom underwent 
      craniotomy and aneurysm clipping. In comparison to the subgroup without NCSE, 
      among those who were diagnosed with this complication there was a significantly 
      greater proportion of men (70 % vs. 34 %; P = 0.041), cases with the Glasgow Coma 
      Scale score at admission < 13 (90 % vs. 36 %; P = 0.004), the Hunt and Hess aSAH 
      grades 3-5 (90 % vs. 45 %; P = 0.013), and hydrocephalus (70 % vs. 29 %; P = 
      0.044). In addition, they required a significantly longer hospital stay (medians, 
      62.5 vs. 39.5 days; P = 0.015) and showed trend for the lower rate of favorable 
      disability outcomes (20 % vs. 54 %; P = 0.084). CONCLUSIONS: NCSE is encountered 
      rather often after the microsurgical clipping of ruptured intracranial aneurysms, 
      especially in severely disabled patients with high-grade aSAH and/or associated 
      hydrocpephalus, and may significantly affect the clinical course and prolong 
      recovery. cEEG monitoring may be helpful for timely diagnosis and treatment of 
      this complication.
CI  - Copyright (c) 2020 Elsevier B.V. All rights reserved.
FAU - Kikuta, Yoshichika
AU  - Kikuta Y
AD  - Department of Neurosurgery, Stroke and Epilepsy Center, TMG Asaka Medical Center, 
      Asaka, Saitama, Japan; Department of Neurosurgery, Tokyo Women's Medical 
      University, Tokyo, Japan.
FAU - Kubota, Yuichi
AU  - Kubota Y
AD  - Department of Neurosurgery, Stroke and Epilepsy Center, TMG Asaka Medical Center, 
      Asaka, Saitama, Japan; Department of Neurosurgery, Tokyo Women's Medical 
      University, Tokyo, Japan; Department of Neurosurgery, Medical Center East, Tokyo 
      Women's Medical University, Tokyo, Japan. Electronic address: 
      kubota.yuichi@twmu.ac.jp.
FAU - Nakamoto, Hidetoshi
AU  - Nakamoto H
AD  - Department of Neurosurgery, Stroke and Epilepsy Center, TMG Asaka Medical Center, 
      Asaka, Saitama, Japan; Department of Neurosurgery, Tokyo Women's Medical 
      University, Tokyo, Japan.
FAU - Chernov, Mikhail
AU  - Chernov M
AD  - Department of Neurosurgery, Medical Center East, Tokyo Women's Medical 
      University, Tokyo, Japan.
FAU - Kawamata, Takakazu
AU  - Kawamata T
AD  - Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan.
LA  - eng
PT  - Journal Article
DEP - 20201008
PL  - Netherlands
TA  - Clin Neurol Neurosurg
JT  - Clinical neurology and neurosurgery
JID - 7502039
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Aneurysm, Ruptured/diagnostic imaging/*surgery
MH  - Cohort Studies
MH  - Endovascular Procedures/*adverse effects/trends
MH  - Female
MH  - Humans
MH  - Incidence
MH  - Intracranial Aneurysm/diagnostic imaging/*surgery
MH  - Male
MH  - Microsurgery/*adverse effects/trends
MH  - Middle Aged
MH  - Postoperative Complications/diagnostic imaging/*epidemiology
MH  - Retrospective Studies
MH  - Status Epilepticus/diagnostic imaging/*epidemiology
MH  - Surgical Instruments/adverse effects
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Aneurysmal subarachnoid hemorrhage
OT  - Incidence
OT  - Nonconvulsive status epilepticus
OT  - Outcome
OT  - Treatment
EDAT- 2020/12/04 06:00
MHDA- 2021/06/22 06:00
CRDT- 2020/12/03 05:31
PHST- 2020/08/11 00:00 [received]
PHST- 2020/10/05 00:00 [revised]
PHST- 2020/10/06 00:00 [accepted]
PHST- 2020/12/04 06:00 [pubmed]
PHST- 2021/06/22 06:00 [medline]
PHST- 2020/12/03 05:31 [entrez]
AID - S0303-8467(20)30641-7 [pii]
AID - 10.1016/j.clineuro.2020.106298 [doi]
PST - ppublish
SO  - Clin Neurol Neurosurg. 2021 Jan;200:106298. doi: 10.1016/j.clineuro.2020.106298. 
      Epub 2020 Oct 8.