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Seizures in Subarachnoid Hemorrhage

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Seizures in Cerebrovascular Disorders

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Abstract

Subarachnoid hemorrhage (SAH) is a rare type of hemorrhagic stroke and frequently associated with seizure disorder. While trauma is a cause of SAH, aneurysm rupture remains the most common cause of nontraumatic SAH. Hemorrhage is classified into three distinct patterns according to blood accumulation within the cranial cavity: diffuse, perimesencephalic, and cortical convexity types. The risk of seizure is the highest among those with diffuse aneurysmal SAH. Seizure is a common complication following SAH and may lead to an increase in the morbidity and mortality; hence, the detection of seizures during the hospital course is important for early treatment and prevention. Seizures following SAH may occur at onset, early (within 2 weeks of onset) and late during the disease course. The risk of early seizures in approximately 5%, whereas late seizures may be 14?% with a mean latency of approximately 8 months from the onset of hemorrhage. The risk of seizure is particularly high among patients with poor-grade SAH (Hunt–Hess grade IV and V and Fisher grade III). Continuous electroencephalography (EEG) monitoring is useful for seizure detection among comatose patients. Advances in treatment and technology of cerebral aneurysms, improved seizure detection methods, and the advancement in neurocritical care management for SAH have led to a lesser seizure frequency, improved seizure control rate, and better clinical outcomes.

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Authors and Affiliations

  1. SSM-Neurosciences Institute, SSM-Neurosciences Institute and St. Louis University, 12255 DePaul Health Drive, Suite 200, St. Louis, Missouri, 63044, USA

    Assoc. Prof. Amer Alshekhlee MD, MSc

  2. Department of Neurology, University of South Carolina School of Medicine, 8 Medical Par, Suite 420, 29203, Colombia, SC, USA

    Sonal Mehta MD

  3. Department of Neurology & Psychiatry, Saint Louis University School of Medicine, 1402 South Grand Blvd C-130, 63104, St. Louis, MO, USA

    L. James Willmore MD

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  1. Department of Neurology Director, Epilepsy Center, George Washington University, Washington DC, District of Columbia, USA

    Mohamad Z. Koubeissi

  2. SSM-Neurosciences Institute and St. Louis University, St. Louis University, Missouri, Missouri, USA

    Amer Alshekhlee

  3. Vascular Neurology Fellow, University of Virginia, Charlottesville, Virginia, Virginia, USA

    Prachi Mehndiratta

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Alshekhlee, A., Mehta, S., Willmore, L. (2015). Seizures in Subarachnoid Hemorrhage. In: Koubeissi, M., Alshekhlee, A., Mehndiratta, P. (eds) Seizures in Cerebrovascular Disorders. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2559-9_4

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