Postcranioplasty seizures following decompressive craniectomy and seizure prophylaxis: A retrospective analysis at a single institution

Mun Chun Yeap, Ching Chang Chen, Zhuo Hao Liu, Po Chuan Hsieh, Cheng Chi Lee, Yu Tse Liu, Alvin Yi Chou Wang, Yin Cheng Huang, Kuo Chen Wei, Chieh Tsai Wu, Po Hsun Tu*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

12 Scopus citations

Abstract

OBJECTIVE Cranioplasty is a relatively simple and less invasive intervention, but it is associated with a high incidence of postoperative seizures. The incidence of, and the risk factors for, such seizures and the effect of prophylactic antiepileptic drugs (AEDs) have not been well studied. The authors' aim was to evaluate the risk factors that predispose patients to postcranioplasty seizures and to examine the role of seizure prophylaxis in cranioplasty. METHODS The records of patients who had undergone cranioplasty at the authors' medical center between 2009 and 2014 with at last 2 years of follow-up were retrospectively reviewed. Demographic and clinical characteristics, the occurrence of postoperative seizures, and postoperative complications were analyzed. RESULTS Among the 583 patients eligible for inclusion in the study, 247 had preexisting seizures or used AEDs before the cranioplasty and 336 had no seizures prior to cranioplasty. Of these 336 patients, 89 (26.5%) had new-onset seizures following cranioplasty. Prophylactic AEDs were administered to 56 patients for 1 week after cranioplasty. No early seizures occurred in these patients, and this finding was statistically significant (p = 0.012). Liver cirrhosis, intraoperative blood loss, and shunt-dependent hydrocephalus were risk factors for postcranioplasty seizures in the multivariable analysis. CONCLUSIONS Cranioplasty is associated with a high incidence of postoperative seizures. The prophylactic use of AEDs can reduce the occurrence of early seizures.

Original languageEnglish
Pages (from-to)936-940
Number of pages5
JournalJournal of Neurosurgery
Volume131
Issue number3
DOIs
StatePublished - 2019

Bibliographical note

Publisher Copyright:
© AANS 2019, except where prohibited by US copyright law.

Keywords

  • Complication
  • Craniectomy
  • Cranioplasty
  • Seizure
  • Seizure prophylaxis
  • Surgical technique

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