ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2021
Delayed hemorrhage after pediatric stereo-electroencephalography: delayed occurrence or delayed diagnosis?
Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed, 6 citations in OpenAlex.
- Hitting the Sulcus With a More Tangential Angle May Result in Resistance Felt During Implantation of Stereotactic Electroencephalography Electrodes.Neurosurgery practice · 2026Article
- Pseudoaneurysms as a complication of stereoelectroencephalography: Case series and clinical recommendations.Epilepsia · 2026Article
- Robot-assisted insular stereoelectroencephalography in pediatric drug-resistant epilepsy: accuracy and diagnostic value.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2024Article
- De novo cerebral pseudoaneurysm formation: a rare delayed complication of stereotactic electroencephalography in children.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2024Article
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8 authors at 3 institutions in 1 country.
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Abstract
backgroundStereo-electroencephalography (SEEG) is a well-known invasive diagnostic method for drug-resistant epilepsy (DRE). Its rate of complications is relatively low, being the intracranial hemorrhage (ICH) the most relevant. Most centers perform immediate imaging studies after SEEG to rule out complications. However, delayed intracranial hemorrhages (DIH) can occur despite normal imaging studies in the immediate postoperative period.
methodsWe performed a retrospective review of DRE pediatric patients operated on SEEG between April 2016 and December 2020 in our institution. After implantation, an immediate postoperative CT was performed to check electrode placement and rule out acute complications. An additional MRI was performed 24 h after surgery. We collected all postoperative hemorrhages and considered them as major or minor according to Wellmer´s classification.
resultsOverall, 25 DRE patients were operated on SEEG with 316 electrodes implanted. Three ICHs were diagnosed on postoperative imaging. Two of them were asymptomatic requiring no treatment, while the other needed surgical evacuation after clinical worsening. The total risk of hemorrhage per procedure was 12%, but just one third of them were clinically relevant. Two hemorrhages were not visible on immediate postoperative CT, being incidentally diagnosed in the 24 h MRI. We recorded them as DIH and are reported in detail.
conclusionFew reports of DIH after SEEG exist in the literature. It remains unclear whether these cases are late occurring hemorrhages or immediate postoperative hemorrhages undiagnosed on initial imaging. According to our findings, we recommend to perform additional late postoperative imaging to diagnose these cases and manage them accurately.
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