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SHR Neuro Cancer Cardio Lipid Metab Microb
Gruber, J; Gattringer, T; Mayr, G; Schwarzenhofer, D; Kneihsl, M; Wagner, J; Sonnberger, M; Deutschmann, H; Haidegger, M; Fandler-Höfler, S; Ropele, S; Enzinger, C; von, Oertzen, T.
Frequency and predictors of poststroke epilepsy after mechanical thrombectomy for large vessel occlusion stroke: results from a multicenter cohort study.
J Neurol. 2023; 270(12):6064-6070
Doi: 10.1007/s00415-023-11966-x
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- Leading authors Med Uni Graz
- Gattringer Thomas
- Co-authors Med Uni Graz
- Deutschmann Hannes
- Enzinger Christian
- Fandler-Höfler Simon
- Haidegger Melanie
- Kneihsl Markus
- Ropele Stefan
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- Abstract:
- BACKGROUND: Poststroke epilepsy (PSE) represents an important complication of stroke. Data regarding the frequency and predictors of PSE in patients with large-vessel occlusion stroke receiving mechanical thrombectomy (MT) are scarce. Furthermore, information on acute and preexisting lesion characteristics on brain MRI has not yet been systematically considered in risk prediction of PSE. This study thus aims to assess PSE risk after acute ischemic stroke treated with MT, based on clinical and MRI features. METHODS: In this multicenter study from two tertiary stroke centers, we included consecutive acute ischemic stroke patients who had received MT for acute intracranial large vessel occlusion (LVO) between 2011 and 2017, in whom post-interventional brain MRI and long term-follow-up data were available. Infarct size, affected cerebrovascular territory, hemorrhagic complications and chronic cerebrovascular disease features were assessed on MRI (blinded to clinical information). The primary outcome was the occurrence of PSE (> 7 days after stroke onset) assessed by systematic follow-up via phone interview or electronic records. RESULTS: Our final study cohort comprised 348 thrombectomy patients (median age: 67 years, 45% women) with a median long-term follow-up of 78 months (range 0-125). 32 patients (9%) developed PSE after a median of 477 days (range 9-2577 days). In univariable analyses, larger postinterventional infarct size, infarct location in the parietal, frontal or temporal lobes and cerebral microbleeds were associated with PSE. Multivariable Cox regression analysis confirmed larger infarct size (HR 3.49; 95% CI 1.67-7.30) and presence of cerebral microbleeds (HR 2.56; 95% CI 1.18-5.56) as independent predictors of PSE. CONCLUSION: In our study, patients with large vessel occlusion stroke receiving MT had a 9% prevalence of PSE over a median follow-up period of 6.5 years. Besides larger infarct size, presence of cerebral microbleeds on brain MRI predicted PSE occurrence.
- Find related publications in this database (using NLM MeSH Indexing)
- Humans - administration & dosage
- Female - administration & dosage
- Aged - administration & dosage
- Male - administration & dosage
- Brain Ischemia - complications, diagnostic imaging, epidemiology
- Ischemic Stroke - complications
- Treatment Outcome - administration & dosage
- Retrospective Studies - administration & dosage
- Stroke - complications, diagnostic imaging, therapy
- Thrombectomy - adverse effects, methods
- Arterial Occlusive Diseases - complications
- Epilepsy - etiology
- Infarction - administration & dosage
- Cerebral Hemorrhage - complications
- Find related publications in this database (Keywords)
- Stroke
- Mechanical thrombectomy
- Endovascular stroke treatment
- Epilepsy
- Poststroke epilepsy