Journal of Neurology

, Volume 243, Issue 2, pp 161–164 | Cite as

Seizures at the onset of subarachnoid haemorrhage

  • A. R. Pinto
  • P. Canhão
  • J. M. Ferro
Original Communication


In a prospective study of 253 patients with subarachnoid haemorrhage, 16 (6.3%) had seizures at the onset of bleeding. None had a previous history of seizures. One was an alcoholic. None had metabolic imbalance. Hemiparesis, Hunt’s grade >3, the amount of subarachnoid blood and the presence of an aneurysm were significantly more frequent in patients with seizures at the onset of subarachnoid haemorrhage. Although rebleeding and mortality or severe disability at discharge were more frequent in these patients, seizures were not a significant predictor of prognosis. One of the survivors with early seizures developed recurrent epileptic seizures 1 year later.

Key words

Subarachnoid haemorrhage Seizures Aneurysm 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Bassi P, Bandera R, Loiero M, Tognoni G, Mangoni A (1991) Warning signs in subarachnoid hemorrhage: a cooperative study. Acta Neurol Scand 84: 277–281PubMedCrossRefGoogle Scholar
  2. 2.
    Biller J, Toffol GJ, Kassell NF, Adams HP Jr, Beck DW, Boarini DJ (1987) Spontaneous subarachnoid hemorrhage in young adults. Neurosurgery 21: 664–667PubMedGoogle Scholar
  3. 3.
    Bonita R, Thomson S (1985) Subarachnoid hemorrhage: epidemiology, diagnosis, management and outcome. Stroke 16: 591–594PubMedGoogle Scholar
  4. 4.
    Commission on Classification and Terminology of the International League Against Epilepsy (1981) Proposal for revised clinical and electroencephalographic classification of epileptic seizures. Epilepsia 2: 489–501Google Scholar
  5. 5.
    Ferro JM, Lopes J, Melo TP, Oliveira V, Crespo M, Campos JG, Trindade A (1991) Investigations into the causes of delayed diagnosis of subarachnoid hemorrhage. Cerebrovasc Dis 1: 160–164Google Scholar
  6. 6.
    Fisher CM (1975) Clinical syndrome in cerebral thrombosis, hypertensive hemorrhage and ruptured saccular aneurysms. In: Wilkins RH (ed) Clinical neurosurgery, vol 22. Williams & Wilkins, Baltimore, pp 135–136Google Scholar
  7. 7.
    Fisher CM, Kistler JP, Davis JM (1980) Relation of cerebral vasospasm to subarachnoid hemorrhage visualized by computerized tomographic scanning. Neurosurgery 6: 1–9PubMedGoogle Scholar
  8. 8.
    Hart RG, Byer JA, Slaughter JR, Hewett JE, Easton JD (1981) Occurrence and implications of seizures in subarachnoid hemorrhage due to ruptured intracranial aneurysms. Neurosurgery 8: 417–421PubMedGoogle Scholar
  9. 9.
    Hasan D, Schonck RSM, Avezaat CJJ, Tanghe HLJ, Gijn J van, Lugt PJM van der (1993) Epileptic seizures after subarachnoid hemorrhage. Ann Neurol 33: 286–291PubMedCrossRefGoogle Scholar
  10. 10.
    Hijdra A, Brouwers PJAM, Gijn J van, Vermeulen M (1990) Grading the amount of blood on computed tomography scans after subarachnoid hemorrhage. Stroke 21: 1156–1161PubMedGoogle Scholar
  11. 11.
    Hunt WE, Hess RM (1968) Surgical risk as related to time of intervention in the repair of intracranial aneurysms. J Neurosurg 28: 14–20PubMedGoogle Scholar
  12. 12.
    Kilpatrick CJ, Davis SM, Tress BM, Rossiter SC, Hopper JL, Vandendriesen ML (1990) Epileptic seizures in acute stroke. Arch Neurol 47: 157–160PubMedGoogle Scholar
  13. 13.
    Lee WL, Hablitz JJ (1991) Initiation of epileptiform activity by excitatory aminoacid receptors in the disinhibited rat neocortex. J Neurophysiol 65: 87–95PubMedGoogle Scholar
  14. 14.
    Locksley HB (1966) Report on the co-operative study of intracranial aneurysms and subarachnoid hemorrhage, section V, part 1. Natural history of subarachnoid hemorrhage, intracranial aneurysms and arteriovenous malformations: based on 6368 cases in the co-operative study. J Neurosurg 25: 219–239PubMedGoogle Scholar
  15. 15.
    Mcdonald RL, Weir BKA (1991) A review of hemoglobin and the pathogenesis of cerebral vasospasm. Stroke 22: 971–982Google Scholar
  16. 16.
    Öhman J (1990) Hypertension as a risk factor for epilepsy after aneurysmal subarachnoid hemorrhage and surgery. Neurosurgery 27: 578–581PubMedCrossRefGoogle Scholar
  17. 17.
    Sarner M, Rose FC (1967) Clinical presentation of ruptured intracranial aneurysm. J Neurol Neurosurg Psychiatry 30: 67–70Google Scholar
  18. 18.
    Sengupta RP, McAllister VL (eds) (1986) Subarachnoid hemorrhage. Springer, Berlin Heidelberg New YorkGoogle Scholar
  19. 19.
    Suzuki J (1979) Cerebral aneurysm. Experience with 1000 directly operated cases. Neuron, Tokyo, pp 35–50Google Scholar
  20. 20.
    Swieten JC van, Koudstaal PJ, Visser MC, Schouten HJA, Gijn J van (1988) Interobserver agreement for the assessment of handicap in stroke patients. Stroke 19: 604–607PubMedGoogle Scholar
  21. 21.
    Toole IF, Robinson MK, Mercuri M (1989) Primary subarachnoid hemorrhage. In: Vinken PJ, Bruyn GW, Klawans HL (ed) Handbook of clinical neurology. Vascular diseases (part III), vol 55. Elsevier, Amsterdam, p 14Google Scholar
  22. 22.
    Walton JN (1956) Subarachnoid haemorrhage. Livingston, EdinburghGoogle Scholar
  23. 23.
    UK-TIA study group (1988) The UK-TIA aspirin trial: interim results. BMJ 296: 316–320CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 1996

Authors and Affiliations

  • A. R. Pinto
    • 1
  • P. Canhão
    • 1
  • J. M. Ferro
    • 1
  1. 1.Department of NeurologyHospital Santa MariaLisboaPortugal

Personalised recommendations