Niels Pacheco-Barrios, Aryan Wadhwa, Tzak S Lau, Max Shutran, Christopher S Ogilvy
{"title":"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》。","authors":"Niels Pacheco-Barrios, Aryan Wadhwa, Tzak S Lau, Max Shutran, Christopher S Ogilvy","doi":"10.1227/neu.0000000000003183","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and objectives: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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%).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":null,"pages":null},"PeriodicalIF":3.9000,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Risk Factors Associated With Seizure After Treatment of Chronic Subdural Hemorrhage: A Systematic Review and Meta-Analysis.\",\"authors\":\"Niels Pacheco-Barrios, Aryan Wadhwa, Tzak S Lau, Max Shutran, Christopher S Ogilvy\",\"doi\":\"10.1227/neu.0000000000003183\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and objectives: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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%).</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":19276,\"journal\":{\"name\":\"Neurosurgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.9000,\"publicationDate\":\"2024-09-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Neurosurgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1227/neu.0000000000003183\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neurosurgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1227/neu.0000000000003183","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Risk Factors Associated With Seizure After Treatment of Chronic Subdural Hemorrhage: A Systematic Review and Meta-Analysis.
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.
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.
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