Risk Factors Associated With Seizure After Treatment of Chronic Subdural Hemorrhage: A Systematic Review and Meta-Analysis.

IF 3.9 2区医学 Q1 CLINICAL NEUROLOGY Neurosurgery Pub Date : 2024-09-30 DOI:10.1227/neu.0000000000003183

Niels Pacheco-Barrios, Aryan Wadhwa, Tzak S Lau, Max Shutran, Christopher S Ogilvy

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Abstract

Background and objectives: Chronic subdural hemorrhage (cSDH) is a prevalent neurosurgical pathology, marked by blood collection between the dura mater and the arachnoid membrane. The aim of this systematic review was to provide a comprehensive overview of the risk factors associated with seizures after cSDH treatment.

Methods: We systematically searched the following databases for studies conducted until September 28, 2023: PubMed, Embase, SCOPUS, Cochrane Central, WOS, and EBSCO. We selected all studies aiming to assess risk factors associated with seizures after treatment of cSDH. Observation studies written in English, Spanish, and Portuguese were included. The quality of studies was assessed using the Newcastle-Ottawa scale for observational studies.

Results: A total of 1830 studies were screened after the elimination of duplicates. A total of 18 studies were included, representing 4966 patients. The pooled proportion of seizures after treatment of cSDH is 10% [95% CI 7%, 13%; I2 = 93%]. The risk of seizures was lower in patients undergoing burr hole surgery compared to craniotomy, with an odds ratio of 0.23 (95% CI [0.10, 0.55]; I2 = 0%). Additionally, the risk of seizures in patients receiving prophylactic antiepileptic treatment compared to those without was higher, with an odds ratio of 2.62 (95% CI [0.53, 13.06]; I2 = 66%).

Conclusion: Burr-hole treatment after cSDH presents a lower risk of seizures compared with craniotomy, and the use of prophylactic antiepileptic treatment did not conclusively affect seizure outcomes. Standardization in the reporting of outcomes and more comparative studies are needed to enable better recognition of risk factors of seizures after cSDH treatment.

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与慢性硬膜下出血治疗后癫痫发作相关的风险因素：系统回顾与元分析》。

背景和目的：慢性硬膜下出血（cSDH）是一种常见的神经外科病理，其特征是硬脑膜和蛛网膜之间的血液聚集。本系统综述旨在全面概述与治疗 cSDH 后癫痫发作相关的风险因素：我们系统检索了以下数据库中截至 2023 年 9 月 28 日的研究：PubMed、Embase、SCOPUS、Cochrane Central、WOS 和 EBSCO。我们选择了所有旨在评估与治疗 cSDH 后癫痫发作相关的风险因素的研究。我们纳入了以英语、西班牙语和葡萄牙语撰写的观察性研究。研究质量采用纽卡斯尔-渥太华观察性研究量表进行评估：结果：在剔除重复研究后，共筛选出 1830 项研究。共纳入 18 项研究，代表 4966 名患者。治疗 cSDH 后癫痫发作的总比例为 10% [95% CI 7%, 13%; I2 = 93%]。与开颅手术相比，接受毛细孔手术的患者癫痫发作的风险较低，几率比为 0.23（95% CI [0.10，0.55]；I2 = 0%）。此外，与未接受预防性抗癫痫治疗的患者相比，接受预防性抗癫痫治疗的患者癫痫发作的风险更高，几率比为 2.62（95% CI [0.53，13.06]；I2 = 66%）：结论：与开颅手术相比，cSDH术后进行爆孔治疗的癫痫发作风险较低，预防性抗癫痫治疗的使用并不会对癫痫发作的结果产生决定性影响。为了更好地识别 cSDH 治疗后癫痫发作的风险因素，需要对结果报告进行标准化并开展更多的比较研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neurosurgery 医学-临床神经学

CiteScore

8.20

自引率

6.20%

发文量

898

审稿时长

2-4 weeks

期刊介绍： Neurosurgery, the official journal of the Congress of Neurological Surgeons, publishes research on clinical and experimental neurosurgery covering the very latest developments in science, technology, and medicine. For professionals aware of the rapid pace of developments in the field, this journal is nothing short of indispensable as the most complete window on the contemporary field of neurosurgery. Neurosurgery is the fastest-growing journal in the field, with a worldwide reputation for reliable coverage delivered with a fresh and dynamic outlook.