TY - JOUR
T1 - Incidence, predictors, and outcome of early seizures after mechanical thrombectomy
AU - Anadani, Mohammad
AU - Lekoubou Looti, Alain Zingraff
AU - Almallouhi, Eyad
AU - Alawieh, Ali
AU - Chatterjee, Arindam
AU - Vargas, Jan
AU - Spiotta, Alejandro M.
N1 - Publisher Copyright:
© 2018 Elsevier B.V.
PY - 2019/1/15
Y1 - 2019/1/15
N2 - Objective: Despite the wide utilization of mechanical thrombectomy (MT) for acute ischemic stroke treatment, little is known about the incidence of early post-thrombectomy seizures, its predictors, and association with long-term outcome. Methods: Using a prospective registry of mechanical thrombectomy in ischemic stroke between January 2013 and July 2017, we identified patients who developed a seizure within 7 days (early seizure) of qualifying event. Backward stepwise regression analysis was used to assess independent predictors of seizure occurrence and the association between seizure and functional outcome (modified Rankin scale of 0–2 vs. ≥3). Results: A total of 459 patients were included in the final analysis. Mean age was 67.5 (SD 15.1), and 49.9% of patients were female. Successful recanalization (TICI≥2B) was achieved in 92.8% of patients. Eleven (2.4%) patients developed at least one seizure. Only an Alberta Stroke Program Early CT (ASPECT) score of <6 was independently associated with the occurrence of early seizures [Odds ratio, 95% confidence interval: 8.188, (2.219–30.214); P =.002]. On multivariate analysis, early seizures were associated with 90-day mortality rate [OR,6.487; 95% confidence interval, (1.481–28.405); P =.013] and poor functional outcome (OR, 4.7; 95% confidence interval (1.08–20.83); p =.039). Conclusion: In the studied cohort, 2.4% of ischemic stroke patients treated with MT developed at least one seizure within 7 days of stroke onset. A low ASPECT score was associated with the occurrence of early seizures. The occurrence of seizures was associated with 90-day mortality and poor functional outcome.
AB - Objective: Despite the wide utilization of mechanical thrombectomy (MT) for acute ischemic stroke treatment, little is known about the incidence of early post-thrombectomy seizures, its predictors, and association with long-term outcome. Methods: Using a prospective registry of mechanical thrombectomy in ischemic stroke between January 2013 and July 2017, we identified patients who developed a seizure within 7 days (early seizure) of qualifying event. Backward stepwise regression analysis was used to assess independent predictors of seizure occurrence and the association between seizure and functional outcome (modified Rankin scale of 0–2 vs. ≥3). Results: A total of 459 patients were included in the final analysis. Mean age was 67.5 (SD 15.1), and 49.9% of patients were female. Successful recanalization (TICI≥2B) was achieved in 92.8% of patients. Eleven (2.4%) patients developed at least one seizure. Only an Alberta Stroke Program Early CT (ASPECT) score of <6 was independently associated with the occurrence of early seizures [Odds ratio, 95% confidence interval: 8.188, (2.219–30.214); P =.002]. On multivariate analysis, early seizures were associated with 90-day mortality rate [OR,6.487; 95% confidence interval, (1.481–28.405); P =.013] and poor functional outcome (OR, 4.7; 95% confidence interval (1.08–20.83); p =.039). Conclusion: In the studied cohort, 2.4% of ischemic stroke patients treated with MT developed at least one seizure within 7 days of stroke onset. A low ASPECT score was associated with the occurrence of early seizures. The occurrence of seizures was associated with 90-day mortality and poor functional outcome.
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U2 - 10.1016/j.jns.2018.11.033
DO - 10.1016/j.jns.2018.11.033
M3 - Article
C2 - 30529800
AN - SCOPUS:85057834799
SN - 0022-510X
VL - 396
SP - 235
EP - 239
JO - Journal of the neurological sciences
JF - Journal of the neurological sciences
ER -