{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T12:50:54Z","timestamp":1783774254417,"version":"3.55.0"},"reference-count":24,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2010,2]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>The purpose of this study was to evaluate the incidence of seizures or epileptiform abnormalities on electroencephalography (EEG) studies in patients undergoing surgical treatment for acute subdural hematoma (SDH).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>This was a retrospective study of 134 consecutive patients with acute or acute-on-chronic SDH who underwent surgical treatment at the authors' institution between January 2004 and July 2008. Detailed information was collected regarding baseline clinical data (including preexistent functional impairment); Glasgow Coma Scale (GCS) sum scores before and 24 hours after surgery; presence of clinical seizures; EEG findings; and functional outcome on discharge and up to the 6-month follow-up. All brain CT scans were reviewed to calculate SDH volume and midline shift. The Glasgow Outcome Scale (GOS) score was used for functional assessment, and GOS scores of 1\u20133 were considered indicative of poor outcome. Univariate and multivariate logistic regression analyses were performed to identify statistical associations.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Clinical seizures or epileptiform changes on EEG were observed during the acute postoperative period in 33 patients (25%). Preexistent functional impairment and seizures\/epileptiform EEG findings after surgery were independently associated with poor functional outcome upon hospital discharge (p &lt; 0.001 for both). Preexistent functional impairment (p &lt; 0.001), lower GCS score before surgery (p = 0.04), and lower GCS score 24 hours after surgery (p = 0.007), but not seizures\/epileptiform EEG findings, were independently associated with poor functional recovery at 1- to 6-month follow-up evaluations. Seizures\/epileptiform EEG findings had a strong association with lower GCS scores after surgery (p = 0.01), and they were more common in patients who underwent evacuation by craniotomy (p = 0.02).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Epileptic complications are common after acute SDH evacuation, and should be suspected in patients with an unanticipated depressed level of consciousness after surgery. Seizures worsen early functional outcome, but delayed favorable recovery is possible. Therefore, one should be cautious when discussing prognosis in the early postoperative period of patients with epileptic complications.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2009.7.jns09392","type":"journal-article","created":{"date-parts":[[2009,8,21]],"date-time":"2009-08-21T16:51:20Z","timestamp":1250873480000},"page":"455-460","source":"Crossref","is-referenced-by-count":63,"title":["Seizures after evacuation of subdural hematomas: incidence, risk factors, and functional impact"],"prefix":"10.3171","volume":"112","author":[{"given":"Alejandro A.","family":"Rabinstein","sequence":"first","affiliation":[{"name":"Departments of Neurology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung Young","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Eulji University Hospital, Daejeon, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie A.","family":"Rudzinski","sequence":"additional","affiliation":[{"name":"Departments of Neurology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Lanzino","sequence":"additional","affiliation":[{"name":"Neurosurgery, Mayo Clinic, Rochester, Minnesota; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-1120455","series-title":"N Engl J Med","first-page":"20","article-title":"A population-based study of seizures after traumatic brain injuries","volume":"338","author":"Annegers","year":"1998"},{"key":"b2-1120455","series-title":"J Neurosurg","first-page":"664","article-title":"Coagulopathy and inhospital deaths in patients with acute subdural hematoma","volume":"109","author":"Bershad","year":"2008"},{"key":"b3-1120455","series-title":"J Clin Neurosci","first-page":"706","article-title":"Early post-operative seizures after burr-hole drainage for chronic subdural hematoma: correlation with brain CT findings","volume":"11","author":"Chen","year":"2004"},{"key":"b4-1120455","series-title":"Clin Electroencephalogr","first-page":"145","article-title":"Acute subdural hematoma and the periodic lateralized epileptiform discharges","volume":"10","author":"Chu","year":"1979"},{"key":"b5-1120455","series-title":"J Neurosurg Sci","first-page":"107","article-title":"Prognosis of isolated acute post-traumatic subdural haematoma","volume":"51","author":"D'Amato","year":"2007"},{"key":"b6-1120455","series-title":"Stroke","first-page":"1799","article-title":"Comparison of the ABC\/2 estimation technique to computer-assisted volumetric analysis of intraparenchymal and subdural hematomas complicating the GUSTO-1 trial","volume":"29","author":"Gebel","year":"1998"},{"key":"b7-1120455","series-title":"Neurosurgery","first-page":"1318","article-title":"Evolution of brain tissue injury after evacuation of acute traumatic subdural hematomas","volume":"55","author":"Hlatky","year":"2004"},{"key":"b8-1120455","series-title":"J Neurosurg","first-page":"858","article-title":"Acute subdural hematomas: an age-dependent clinical entity","volume":"71","author":"Howard","year":"1989"},{"key":"b9-1120455","series-title":"J Clin Neurophysiol","first-page":"14","article-title":"Continuous EEG monitoring in the neuroscience intensive care unit and emergency department","volume":"16","author":"Jordan","year":"1999"},{"key":"b10-1120455","series-title":"Acta Neurochir (Wien)","first-page":"95","article-title":"Acute subdural haematoma in adults: an analysis of outcome in comatose patients","volume":"121","author":"Kotwica","year":"1993"},{"key":"b11-1120455","series-title":"Can J Neurol Sci","first-page":"40","article-title":"Early seizures after severe closed head injury","volume":"24","author":"Lee","year":"1997"},{"key":"b12-1120455","series-title":"Bull Los Angeles Neurol Soc","first-page":"8","article-title":"Periodic lateralized epileptiform discharges associated with subdural hematoma","volume":"40","author":"Mehryar","year":"1975"},{"key":"b13-1120455","series-title":"J Neurol Neurosurg Psychiatry","first-page":"1231","article-title":"Low incidence of seizures in patients with chronic subdural haematoma","volume":"56","author":"Ohno","year":"1993"},{"key":"b14-1120455","series-title":"Surg Neurol","first-page":"22","article-title":"Outcome and outcome prediction in acute subdural hematoma","volume":"40","author":"Phuenpathom","year":"1993"},{"key":"b15-1120455","series-title":"Surg Neurol","first-page":"579","article-title":"Chronic subdural hematomas and seizures: the role of prophylactic anticonvulsive medication","volume":"43","author":"Sabo","year":"1995"},{"key":"b16-1120455","series-title":"Acta Neurochir (Wien)","first-page":"531","article-title":"The effect of haematoma, brain injury, and secondary insult on brain swelling in traumatic acute subdural haemorrhage","volume":"150","author":"Sawauchi","year":"2008"},{"key":"b17-1120455","series-title":"J Stroke Cerebrovasc Dis","first-page":"192","article-title":"Predictors of outcomes after nontraumatic subdural hematoma","volume":"13","author":"Schneck","year":"2004"},{"key":"b18-1120455","series-title":"Acta Neurochir (Wien)","first-page":"279","article-title":"Prognostic factors in severely head injured adult patients with acute subdural haematoma's","volume":"139","author":"Servadei","year":"1997"},{"key":"b19-1120455","series-title":"Br J Neurosurg","first-page":"110","article-title":"CT prognostic factors in acute subdural haematomas: the value of the \u2018worst\u2019 CT scan","volume":"14","author":"Servadei","year":"2000"},{"key":"b20-1120455","series-title":"Chin Med J (Engl)","first-page":"1080","article-title":"Risk factors related to hospital mortality in patients with isolated traumatic acute subdural haematoma: analysis of 308 patients undergone 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