Title:
Inaugural Epileptic Seizures Occurrence During or Immediately After Surgical Evacuation of Chronic Subdural Hematoma

Authors:
Diallo Moussa, Tokpa André, Traoré Youssouf, Sogoba Youssouf, Kourouma Djéné, Diallo Oumar, Kanikomo Drissa, Mali

Abstract:

Abstract

We report a series of 9 patients who presented an initial epileptic seizure occurred during or immediately after surgery for a chronic subdural hematoma. Through literature data, we discuss the problem of anticonvulsant prophylaxis and its modalities in patients undergoing surgical evacuation of chronic subdural hematoma.

Materials and study Method

We carried out a retrospective and descriptive study over a period of 24 months. It involved adult patients who had an initial epileptic seizure during or immediately after surgical evacuation of chronic subdural hematoma (CSDH). The epidemiological, clinical and therapeutic parameters were studied.

Results

An epileptic seizure occurred during or immediately after chronic subdural hematoma surgery in 9 of the 69 patients who were operated. Our cohort was composed of 6 men and 3 women with an average age of 73.7 years. The average symptom duration was 19 days. Eight patients were classified MARKWALDER grade II. The hematoma was hemispherical and localized on the left side in 4 patients and partitioned in 5 patients. The seizure occurred during surgery in 5 patients and immediately after surgery in 2 others. It was generalized tonico-clonic seizure in 6 patients. Sodium valproate has been established as a background treatment in our cohort. The average length of hospital stay was 9 days. The evolution was favourable in 6 patients. Two patients died of refractory epilepsy.

Conclusion

Epileptic seizure occurrence can complicate surgical outcome of chronic subdural hematoma. Preventive treatment should be discussed if there are factors that could increase the risk of developing epilepsy.