1. Status Epilepticus after mechanical thrombectomy: The role of early EEG assessment in Stroke Unit, clinical and radiological prognostication.
- Author
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Prandin G, Furlanis G, Scali I, Palacino F, Mancinelli L, Vincis E, Caruso P, Mazzon G, Tomaselli M, Naccarato M, and Manganotti P
- Subjects
- Humans, Male, Female, Aged, Retrospective Studies, Middle Aged, Prognosis, Ischemic Stroke surgery, Ischemic Stroke physiopathology, Ischemic Stroke diagnostic imaging, Stroke surgery, Stroke physiopathology, Aged, 80 and over, Risk Factors, Brain Ischemia physiopathology, Brain Ischemia surgery, Status Epilepticus physiopathology, Status Epilepticus diagnostic imaging, Electroencephalography methods, Thrombectomy methods
- Abstract
Background: Convulsive (CSE) and non-convulsive (NCSE) Status Epilepticus are a complication in 0.2-0.3% ischemic strokes. Large stroke and cortical involvement are the main risk factors for developing SE. This study evaluates the prevalence of SE in patients treated with endovascular thrombectomy (EVT) through EEG recording within 72- h from admission. Moreover, we compared clinical, radiological, and outcome measures in SE and no-SE patients., Materials and Methods: We collected retrospectively demographical and clinical characteristics of acute ischemic stroke patients who underwent EVT, admitted in the Stroke Unit (SU) of the University Hospital of Trieste between January 2018 and March 2020 who underwent EEG recording within 72- h from the symptoms' onset., Results: Out of 247 EVT patients, 138 met the inclusion criteria, of whom 9 (6.5%) showed SE with median onset time of 1 day (IQR 1-2). No difference was found between the two groups as for age, sex, risk factors, grade of recanalization, etiology of stroke, and closed vessel. The no-SE group presented higher NIHSS improvement rate (p=0.025) compared to the SE group. The sum of the lobes involved in the ischemic lesion was significantly higher in SE group (p=0.048)., Conclusion: SE after EVT in large strokes is a non-rare complication, with most being NCSE. Performing a rapid EEG assessment in a Stroke Unit setting may allow for a prompt recognition and treatment of SE in the acute/hyper-acute phase. SE may be correlated with worse clinical outcomes in patients with large vessel occlusion., Competing Interests: Declaration of Copmeting Interest None., (Copyright © 2024 Elsevier B.V. All rights reserved.)
- Published
- 2024
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