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Query: UMLS:C0036572 (seizures)
 80,221 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Forty-nine patients operated during an early clipping phase of cerebral aneurysm were reviewed; none had an associated ventricular flooding and/or intraparenchymal hematoma. Starting from the day of operation 37 patients were treated with anticonvulsant drugs using methods and dosages where were unlikely to guarantee efficacious cover. Forty-two patients made a satisfactory recovery, 5 patients died and 2 had severe neurological sequelae; 2 patients (4.4%) had early seizures during the first week after operation. In view of the inadequate cover of the anticonvulsant drugs and the homogeneous clinical characteristics of patients included in the study, the low number of attacks suggests an overall re-evaluation of anticonvulsant treatment and the need to select patients with a higher risk of an epileptic attack.
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PMID:[Risk of postoperative epilepsy in acute surgery of cerebral aneurysms]. 162 Apr 26

Recurrent transient neurologic deficits were evaluated clinically in four patients. In three patients, the symptoms included recurrent transient homonymous hemianopia, episodic weakness and numbness of the left arm and leg, and recurrent sudden loss of speech and of strength in the right arm. In these three patients, the episodes were first thought to be transient ischemic attacks (TIAs). A fourth patient had repeated confusional spells, in which a recurrent musical theme excluded other thoughts. This was associated with dizziness and difficulty in naming. A partial complex seizure was thought responsible. In each of the cases the symptoms lasted less than 30 minutes and were not associated with loss of consciousness, headache, or stiff neck. Electroencephalogram (EEG), brain scan, lumbar puncture, and computed tomography (CT) scan were normal. In all patients, cerebral arteriography unexpectedly revealed an unruptured cerebral aneurysm. The locations of the aneurysms were appropriate to the symptoms, which remitted in the three patients treated surgically for the aneurysm. Although the pathophysiology is uncertain, an ischemic process may be implicated.
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PMID:Unruptured cerebral aneurysms presenting as recurrent transient neurologic deficits. 718 33

Ruptured aneurysms of the cerebrovasculature in infancy and early childhood, except for "giant" aneurysms and arteriovenous malformations, are rare. Seizures, loss of consciousness, and apnea are the usual presenting signs in infancy; symptoms such as headache or visual disturbances and signs such as cranial nerve compression or meningeal irritation commonly found in older children or adults are absent in infants. However, the morphologic findings (i.e., subarachnoid and retinal hemorrhage, and occasionally subdural hemorrhage) may be mistaken for inflicted trauma, especially if the aneurysm is not identified. Sudden death caused by rupture of a cerebral aneurysm has not been previously described in an infant. This report outlines the investigation and autopsy findings in a 7-month-old infant who died unexpectedly as a result of rupture of a complex basilar artery aneurysm.
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PMID:Sudden death in an infant caused by rupture of a basilar artery aneurysm. 1041 66

Ruptured aneurysms of the cerebrovasculature in infancy and early childhood, except for "giant" aneurysms and arteriovenous malformations, are rare. Seizures, loss of consciousness, and apnea are the usual presenting signs in infancy; symptoms such as headache or visual disturbances and signs such as cranial nerve compression or meningeal irritation commonly found in older children or adults are absent in infants. However, the morphologic findings (i.e., subarachnoid and retinal hemorrhage, and occasionally subdural hemorrhage) may be mistaken for inflicted trauma, especially if the aneurysm is not identified. Sudden death caused by rupture of a cerebral aneurysm has not been previously described in an infant. This report outlines the investigation and autopsy findings in a 7-month-old infant who died unexpectedly as a result of rupture of a complex basilar artery aneurysm.
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PMID:Sudden death in an infant caused by rupture of a basilar artery aneurysm. 1020 36

Seizures as a presenting feature of unruptured cerebral aneurysm are unusual. We report two cases of unruptured cerebral aneurysm presented with seizures. In both cases the seizures controlled following surgical ablation of the aneurysm.
Seizure 1999 Aug
PMID:Unruptured cerebral aneurysms causing seizure disorder (report of two cases). 1048 97

The incidences of postoperative seizures and side effects were evaluated in 193 patients with cerebral aneurysm who received anticonvulsant prophylaxis and underwent 224 craniotomies for cerebral aneurysms between 1993 and 1995. The patients were 73 males and 120 females aged between 31 and 80 years. One hundred and sixteen patients had ruptured cerebral aneurysms and 108 had unruptured aneurysms. Phenytoin followed by valproic acid were administered. Early postoperative seizures occurred in five patients (4 with ruptured and 1 with unruptured aneurysms) within 14 days after surgery. Late postoperative seizures occurred in four different patients with ruptured aneurysms more than 14 days after surgery. The presence of cortical lesions detected by cerebral computed tomography and occurrence of symptomatic vasospasm were correlated with the occurrence of early postoperative seizure (p < 0.05). Three of the four patients with late postoperative seizure had cortical lesions and two were receiving continued medication. Side effects that warranted discontinuation of therapy were seen in the follow-up period in 12.9% of patients. Anticonvulsant prophylaxis is not recommended due to the higher incidence of side effects than seizure, except in patients in poor clinical condition for the purpose of brain protection. Otherwise, anticonvulsant medication should be initiated at the time of the initial seizure attack.
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PMID:Postoperative anticonvulsant prophylaxis for patients treated for cerebral aneurysms. 1063 8

Right middle cerebral artery embolism by thrombus occurred in 63-year-old female during endovascular embolisation of cerebral aneurysm by Guglielmi detachable coil. Middle cerebral artery occlusion lasted for 60 minute, and haemodynamics was stable during this period. Middle cerebral artery occlusion was detected only by digital subtraction angiography and information from neurosurgeons. Middle cerebral artery blood flow was restored with thrombolytic agents. After tracheal extubation, transient confusion and seizure occurred, but cerebral infarction was not seen in postoperative CT and there was no complication. In case of endovascular embolisation of cerebral aneurysm by Guglielmi detachable coil, systemic heparinization is necessity to decrease the risk of embolism by thrombus, and anesthetist is required to pay attention to cerebral angiography to maintain, close relationship with neurosurgeons and to take measures for cerebral protection.
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PMID:[Right middle cerebral artery occlusion during endovascular embolisation of cerebral aneurysm by Guglielmi detachable coil: a case report]. 1102 61

Clinicians become concerned when ECT is contemplated in an individual with a neurological disorder. In this review, the authors summarize the reports on the use of ECT in the presence of neurological disease. Because blood pressure, cerebral blood flow, and intracranial pressure rise with ECT, space-occupying lesions with increased intracranial pressure, cerebral aneurysm, recent head trauma, or active CNS infection pose special concerns for ECT treatment. In this review, we conclude that epilepsy and states with lowered seizure threshold may predispose to prolonged seizures. A history of head injury or stroke probably does not increase risk. Toxic/metabolic disorders are not contraindications to ECT, although correction of the underlying imbalance is a first priority. Extrapyramidal, demyelinating, and neuromuscular disorders pose little increased risk. Indeed, in Parkinson's Disease, ECT may be beneficial for the motor symptoms. As a general rule, it seems advisable to treat the underlying disorder prior to beginning ECT.
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PMID:ECT and Neurological Disorders. 1194 Sep 5

Systemic lupus erythematosus is a multifactorial autoimmune disease of complex etiology, which may be associated with cognitive dysfunction, seizures, and headache. The authors present an unusual presentation of systemic lupus erythematosus complicated by global cerebral edema and subarachnoid hemorrhage secondary to rupture of a cerebral aneurysm. The complicated patient management issues are discussed.
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PMID:Global cerebral edema and subarachnoid hemorrhage in a patient with systemic lupus erythematosus. 1502 Dec 88

The management of unruptured cerebral aneurysm is controversial. Because the natural history of unruptured cerebral aneurysm is not well defined, the best management strategy is unclear. The current consensus on the management of unruptured cerebral aneurysm includes observation, microsurgical clipping, and endovascular treatment. The methodologies used to follow up a known unruptured aneurysm are controversial and may be dependent on the preferences of the treating physician. Most aneurysms are managed by the neurosurgeons and interventional neuroradiologists, but neurologists often are the first to discover the unruptured aneurysms when screening the patients for other neurologic disorders. Therefore, the knowledge on when to screen patients for and how to best manage an unruptured aneurysm will have a direct impact on their daily practices. Unruptured aneurysms often cause other neurologic symptoms including ischemic events, seizures, and headache. These symptoms may prompt more interventional treatment. Without a thoughtfully designed, true population-based study or randomized trial, the current best management will be based on the available literature and the temporal profile of each patient.
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PMID:Treatment Options for Unruptured Cerebral Aneurysm. 1546 23


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