In a nutshell
This paper studied a way to measure the risk of seizures after an intracerebral haemorrhage.
Some background
Acute intracerebral hemorrhage occurs when there is sudden bleeding in the brain. It is a common cause of seizures (abnormal electrical activity in the brain causing violent shaking). These seizures can be classified into early or late seizures, depending on when they occur. Early and late seizures have different outcomes. Late seizures are relatively common, and measures are usually taken to prevent them. It would be useful to be able to identify patients at high risk of late seizures. However, such a tool does not yet exist.
Methods & findings
This study analyzed the records of 993 patients with intracerebral hemorrhage were analyzed. 11% of patients had an early seizure. 90% of early seizures occurred during the first 3 days after the intracerebral haemorrhage.
9.2% of patients had a late seizure. The average time to a late seizure was 0.5 years. After 1 year, 7.1% of patients had a late seizure. After 5 years, 11.8% of patients had a late seizure. 27% of patient with early seizures had late seizures.
A score system, called the CAVE score, was developed. If the original hemorrhage involved only the cortex of the brain, the patient was given 1 point. 1 point was given if the patient was less than 65 years old. 1 point was given if the volume of bleeding during hemorrhage was greater than 10 ml. 1 point was given if the early seizure occurred within 7 days of the haemorrhage. These points were added up to measure the risk of a late seizure.
A total of 0 points led to an increased risk of 0.6%. 1 point led to an increased risk of 3.6%. 2 points led to an increased risk of 9.8%. 3 points led to an increased risk of 34.8%. 4 points led to an increased risk of 46.2%.
The bottom line
The authors concluded that the CAVE score may help doctors estimate the risk of late seizures in patients.
The fine print
At the moment, the CAVE score cannot be used for treatment decisions. It is used as a predictive tool.
Published By :
Stroke
Date :
Jun 01, 2014
