{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T16:20:12Z","timestamp":1787934012384,"version":"build-2784847793"},"reference-count":17,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2011,12]]},"abstract":"\n Object<\/jats:title>\n The aim of this study was to determine the probability of seizures after treatment of a ruptured cerebral aneurysm by clip occlusion and coil embolization, and to identify the risks and predictors of seizures over the shortand long-term follow-up period.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The study population included 2143 patients with ruptured intracranial aneurysms who were enrolled in 43 centers and randomly assigned to clip application or coil placement. Those patients suffering a seizure were identified prospectively at various time points after randomization, as follows: before treatment; after treatment and before discharge; after discharge to 1 year; and annually thereafter.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Two hundred thirty-five (10.9%) of the 2143 patients suffered a seizure after randomization; 89 (8.3%) of 1073 and 146 (13.6%) of 1070 in the endovascular and neurosurgical allocations, respectively (p = 0.014). In 19 patients the seizure was associated with a rehemorrhage. Of those patients who underwent coil placement alone, without additional procedures, 52 suffered a seizure, and in the group with clip occlusion alone, 91 patients suffered a seizure.<\/jats:p>\n The risk of a seizure after discharge in the endovascular group was 3.3% at 1 year and 6.4% at 5 years. In the neurosurgical group it was 5.2% at 1 year and 9.6% at 5 years. The risk of seizure was significantly greater in the neurosurgical group at both 2 years and at up to 14 years (p = 0.005 and p = 0.013, respectively). The significant predictors of increased risk were as follows: neurosurgical treatment allocation, hazard ratio (HR) 1.64 (95% CI 1.19\u20132.26); younger age, HR 1.54 (95% CI 1.14\u20132.13); Fisher grade > 1 on CT scans, HR 1.34 (95% CI 0.62\u20132.87); delayed ischemic neurological deficit due to vasospasm, HR 2.10 (95% CI 1.49\u20132.94); and thromboembolic complication, HR 5.08 (95% CI 3.00\u20138.61). A middle cerebral artery (MCA) aneurysm location was also a significant predictor of increased risk in both groups; the HR was 2.23 (95% CI 1.57\u20133.17), with the probability of seizure at 6.1% and 11.5% at 1 year in the endovascular and neurosurgery groups, respectively.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The risk of seizures after coil embolization is significantly lower than that after clip occlusion. An MCA aneurysm location increased the risk of seizures in both groups.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2011.6.jns101836","type":"journal-article","created":{"date-parts":[[2011,8,5]],"date-time":"2011-08-05T10:07:25Z","timestamp":1312538845000},"page":"1159-1168","source":"Crossref","is-referenced-by-count":61,"title":["Epilepsy after subarachnoid hemorrhage: the frequency of seizures after clip occlusion or coil embolization of a ruptured cerebral aneurysm"],"prefix":"10.3171","volume":"115","author":[{"given":"Yvonne","family":"Hart","sequence":"first","affiliation":[{"name":"1Department of Neurology, Royal Victoria Infirmary, Newcastle Upon Tyne;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Sneade","sequence":"additional","affiliation":[{"name":"2Oxford Neurovascular and Neuroradiology Research Unit, Nuffield Department of Surgical Sciences, University of Oxford; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline","family":"Birks","sequence":"additional","affiliation":[{"name":"3Centre for Statistics in Medicine, Wolfson College, University of Oxford, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan","family":"Rischmiller","sequence":"additional","affiliation":[{"name":"2Oxford Neurovascular and Neuroradiology Research Unit, Nuffield Department of Surgical Sciences, University of Oxford; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Kerr","sequence":"additional","affiliation":[{"name":"2Oxford Neurovascular and Neuroradiology Research Unit, Nuffield Department of Surgical Sciences, University of Oxford; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Molyneux","sequence":"additional","affiliation":[{"name":"2Oxford Neurovascular and Neuroradiology Research Unit, Nuffield Department of Surgical Sciences, University of Oxford; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns101836","doi-asserted-by":"crossref","first-page":"1620","DOI":"10.1136\/jnnp.2003.026856","volume":"75","author":"Buczacki SJ","year":"2004","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"b2-jns101836","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000047672.25068.4A"},{"key":"b3-jns101836","doi-asserted-by":"publisher","DOI":"10.3340\/jkns.2009.46.2.93"},{"key":"b4-jns101836","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000038906.71394.DE"},{"key":"b5-jns101836","volume-title":"At a Glance Guide to the Current Medical Standards of Fitness to Drive","author":"Drivers Medical Group (UK)","year":"2010"},{"key":"b6-jns101836","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1111\/j.1528-1157.1994.tb02540.x","volume":"35","author":"Giroud M","year":"1994","journal-title":"Epilepsia"},{"key":"b7-jns101836","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1002\/ana.410330310","volume":"33","author":"Hasan D","year":"1993","journal-title":"Ann Neurol"},{"key":"b8-jns101836","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1227\/00006123-198512000-00004","volume":"17","author":"Ker\u00e4nen T","year":"1985","journal-title":"Neurosurgery"},{"key":"b9-jns101836","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.108.517805"},{"key":"b10-jns101836","doi-asserted-by":"publisher","DOI":"10.3171\/jns.2003.99.6.0978"},{"key":"b11-jns101836","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)11314-6"},{"key":"b12-jns101836","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67214-5"},{"key":"b13-jns101836","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1227\/00006123-199010000-00012","volume":"27","author":"Ohman J","year":"1990","journal-title":"Neurosurgery"},{"key":"b14-jns101836","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1111\/j.1528-1157.2000.tb00326.x","volume":"41","author":"Olafsson E","year":"2000","journal-title":"Epilepsia"},{"key":"b15-jns101836","doi-asserted-by":"publisher","DOI":"10.3171\/2010.6.JNS091486"},{"key":"b16-jns101836","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.55.2.258"},{"key":"b17-jns101836","doi-asserted-by":"publisher","DOI":"10.1007\/BF01809452"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/115\/6\/article-p1159.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/thejns.org\/doi\/pdf\/10.3171\/2011.6.JNS101836","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,5,1]],"date-time":"2020-05-01T23:33:19Z","timestamp":1588375999000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/115\/6\/article-p1159.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,12]]},"references-count":17,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.3171\/2011.6.jns101836","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,12]]}}}