뇌동맥류 파열 환자에서 경련발작의 임상적 의의

Abstract

Despite recent advances in the care of such patients, subarachnoid haemorrhage(SAH) due to ruptured intracerebral aneurysm continues to carry a high rate of morbidity and mortality. During the acute phase of SAH, various factors can aggravate a patients initial good neurological state, and every effort should thus be made to prevent such occurrences. Although not a major problem, seizure is a well known factor influencing the course of the disease. The authors studied 476 cases of SAH occurring during the preceding eight-year period and reported the incidence of seizure, the risk factors which evoke it, and the optimal time required to prevent it. The incidence was 11%, and 48% of seizures occurred within three days of SAH. The risk factors were Hunt-Hess grade at admission, degree of neurologic deficit, and the presence and timing of rebleeding. Regardless of initial grade, seizure led to a poorer outcome. We conclude that seizure in aneurysmal subarachnoid hemorrhage occurs during the early stage of the disease and aggravates the prognosis. The recognition of risk factors and early prevention of seizure are thus necessary.