Nikitin N., Panountsev V.
Polenov Research Neurosurgical Institute, Saint Petersburg, Russia
Catamnesis of 307 cases, operated for intracranial aneurysms, was studied. A period of supervision varied from 4 up to 18 years. It was found out, that 32 cases (10.5%) had developed epileptic syndrome (more than 2 seizures) during 1month-16 years after operation; it had happened during the first two years in 15 of them (66%). Worsening of life quality and a state, caused by this syndrome, was watched in 15 out of 32 cases. Constant taking of anticonvulsants was typical of 15 patients; 12 cases took them from time to time and 5 cases did not take them at all. Frequent seizures (more than 3 times a month) were observed in 2 cases only. Risk factors, conditioning epilepsy development in the nearest and remote periods of surgical treatment, included localization of the MCA aneurysm (p<0.001), a combination with intracranial developmental defects (AVM and others) (p<0.05). As for surgical factors, repeated interventions on aneurysm (p<0.001), brain traction during more than 3 hours (p<0.01), guided arterial hypotension (p<0.001), postoperative thrombosis of a parent vessel (p<0.05), hemorrhagic complications (p<0.001), meningitis (p<0.01), seizures in an early postoperative period (p<0.05) and ischemic areas, revealed by control CT, had reliable correlation with future epilepsy development. Taking of anticonvulsants and its duration did not prevent future development of epileptic syndrome (p>0.05). The rate of returning to working activity was reliably lower in cases with seizures (p<0.05). Epileptic syndrome was a cause of its further cessation in those cases (50%), who had already started to work (p<0.001). Epileptic syndrome worsened life quality of patients (47%; p<0.001).