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chronic_subdural_hematoma_seizure_prophylaxis

Chronic subdural hematoma seizure prophylaxis

2013

No formal recommendations can be made about the use of prophylactic anticonvulsants in patients with chronic subdural hematoma based on the literature currently available till 2013. There are no randomised controlled trials on this topic, and non-controlled studies have conflicting results. There is an urgent need for well-designed randomised controlled trials 1).

2012

Patients suffering from seizures may have worse outcome. The benefit of a systematic perioperative prophylaxis using antiepileptic drugs has to be evaluated 2).

2009

The finding in the study of Grobelny et al.demonstrates that preoperative AED prophylaxis likely reduces the incidence of postoperative seizures in patients with CSDH treated with bur hole drainage. A future prospective randomized study is necessary to evaluate the effect of seizure reduction on clinical outcome 3).

2005

No formal recommendations can be made about the use of prophylactic anticonvulsants in patients with chronic subdural haematoma based on the literature currently available. Non-controlled studies came up with conflicting results. There is an urgent need for well-designed randomised controlled trials 4).

2004

Post-operative seizure rate appeared high in the group with mixed-density type lesions on CT, and in those with left unilateral CSDH and suggest the use of prophylactic anticonvulsants for patients with mixed-density lesions on pre-operative CT 5).

1995

The onset of new seizures was found in 17 (18.5%) of 92 patients and was associated with increases in morbidity and mortality. Patients who received prophylactic ACM demonstrated a significant decrease in the occurrence of seizures, and we therefore recommend the use of phenytoin prophylaxis in patients treated surgically for chronic subdural hematoma 6).

1993

A study suggests that routine use of antiepileptic prophylaxis is not justified in patients with chronic subdural haematoma caused by minor head injuries, or other causes when there are no additional lesions present on CT scans 7).

1)
Ratilal BO, Pappamikail L, Costa J, Sampaio C. Anticonvulsants for preventing seizures in patients with chronic subdural haematoma. Cochrane Database Syst Rev. 2013 Jun 6;6:CD004893. doi: 10.1002/14651858.CD004893.pub3. Review. PubMed PMID: 23744552.
2)
Battaglia F, Lubrano V, Ribeiro-Filho T, Pradel V, Roche PH. [Incidence and clinical impact of seizures after surgery for chronic subdural haematoma]. Neurochirurgie. 2012 Aug;58(4):230-4. doi: 10.1016/j.neuchi.2012.04.002. Epub 2012 May 22. French. PubMed PMID: 22626817.
3)
Grobelny BT, Ducruet AF, Zacharia BE, Hickman ZL, Andersen KN, Sussman E, Carpenter A, Connolly ES. Preoperative antiepileptic drug administration and the incidence of postoperative seizures following bur hole-treated chronic subdural hematoma. J Neurosurg. 2009 Dec;111(6):1257-62. doi: 10.3171/2009.6.JNS0928. PubMed PMID: 19558304.
4)
Ratilal B, Costa J, Sampaio C. Anticonvulsants for preventing seizures in patients with chronic subdural haematoma. Cochrane Database Syst Rev. 2005 Jul 20;(3):CD004893. Review. Update in: Cochrane Database Syst Rev. 2013;6:CD004893. PubMed PMID: 16034955.
5)
Chen CW, Kuo JR, Lin HJ, Yeh CH, Wong BS, Kao CH, Chio CC. Early post-operative seizures after burr-hole drainage for chronic subdural hematoma: correlation with brain CT findings. J Clin Neurosci. 2004 Sep;11(7):706-9. PubMed PMID: 15337129.
6)
Sabo RA, Hanigan WC, Aldag JC. Chronic subdural hematomas and seizures: the role of prophylactic anticonvulsive medication. Surg Neurol. 1995 Jun;43(6):579-82. PubMed PMID: 7482238.
7)
Ohno K, Maehara T, Ichimura K, Suzuki R, Hirakawa K, Monma S. Low incidence of seizures in patients with chronic subdural haematoma. J Neurol Neurosurg Psychiatry. 1993 Nov;56(11):1231-3. Review. PubMed PMID: 8229039; PubMed Central PMCID: PMC489829.
chronic_subdural_hematoma_seizure_prophylaxis.txt · Last modified: 2015/03/01 10:21 (external edit)