ArticleCerebrovascular diseases extra2017
High Risk of Seizures and Epilepsy after Decompressive Hemicraniectomy for Malignant Middle Cerebral Artery Stroke .
Article in Cerebrovascular diseases extra, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Decompressive hemicraniectomy as a salvage therapy in the Neuro-ICU: a meta-analysis of neurologic outcomes for malignant middle cerebral artery infarction.Frontiers in medicine · 2026Pooled it
- Strokectomy for malignant middle cerebral artery infarction: experience and meta-analysis of current evidence.Journal of neurology · 2022Pooled it
- Seizures after decompressive surgery for cerebral venous thrombosis.Journal of neurology · 2025Article
- Craniectomy Combined with Rapid Internal Decompression in Massive Cerebral Infarction : Surgical Technique and Outcomes.Journal of Korean Neurosurgical Society · 2025Article
- Severely Hypoperfused Brain Tissue Correlates with Final Infarct Volume Despite Recanalization in DMVO Stroke.Journal of the Belgian Society of Radiology · 2023Article
- Hospital Revisits for Post-Ischemic Stroke Epilepsy after Acute Stroke Interventions.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2022Article
- Is Spreading Depolarization a Risk Factor for Late Epilepsy? A Prospective Study in Patients with Traumatic Brain Injury and Malignant Ischemic Stroke Undergoing Decompressive Craniectomy.Neurocritical care · 2021Observational
- Timing of Decompressive Craniectomy for Malignant Middle Cerebral Artery Infarction: A Single-Center Analysis.Medicina (Kaunas, Lithuania) · 2019Article
- Risk Factors for Epilepsy After Thrombolysis for Ischemic Stroke: A Cohort Study.Frontiers in neurology · 2019Article
- Strokectomy and Extensive Cisternal CSF Drain for Acute Management of Malignant Middle Cerebral Artery Infarction: Technical Note and Case Series.Frontiers in neurology · 2019Article
- Complications of Decompressive Craniectomy.Frontiers in neurology · 2018Review
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDecompressive hemicraniectomy (DHC) is a life-saving procedure for treatment of large malignant middle cerebral artery (MCA) strokes. Post-stroke epilepsy is an additional burden for these patients, but its incidence and the risk factors for its development have been poorly investigated.
objectiveTo report the prevalence and risk factors for post-stroke seizures and post-stroke epilepsy after DHC for treatment of large malignant MCA strokes in a cohort of 36 patients.
methodsIn a retrospective cohort study of 36 patients we report the timing and incidence of post-stroke epilepsy. We analyzed if age, sex, vascular risk factors, side of ischemia, reperfusion therapy, stroke etiology, extension of stroke, hemorrhagic transformation, ECASS scores, National Institutes of Health Stroke Scale (NIHSS) scores, or modified Rankin scores were risk factors for seizure or epilepsy after DHC for treatment of large MCA strokes.
resultsThe mean patient follow-up time was 1,086 days (SD = 1,172). Out of 36 patients, 9 (25.0%) died before being discharged. After 1 year, a total of 11 patients (30.6%) had died, but 22 (61.1%) of them had a modified Rankin score ≤4. Thirteen patients (36.1%) developed seizures within the first week after stroke. Seizures occurred in 22 (61.1%) of 36 patients (95% CI = 45.17-77.03%). Out of 34 patients who survived the acute period, 19 (55.9%) developed epilepsy after MCA infarcts and DHC (95% CI = 39.21-72.59%). In this study, no significant differences were observed between the patients who developed seizures or epilepsy and those who remained free of seizures or epilepsy regarding age, sex, side of stroke, presence of the clinical risk factors studied, hemorrhagic transformation, time of craniectomy, and Rankin score after 1 year of stroke.
conclusionThe incidence of seizures and epilepsy after malignant MCA infarcts submitted to DHC might be very high. Seizure might occur precociously in patients who are not submitted to anticonvulsant prophylaxis. The large stroke volume and the large cortical ischemic area seem to be the main risk factors for seizure or epilepsy development in this subtype of stroke. .
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