Risk factors for the development of seizures after cranioplasty in patients that sustained traumatic brain injury: a systematic review

Publication date: Available online 21 March 2019Source: SeizureAuthor(s): Robert Spencer, Susruta Manivannan, Feras Sharouf, Muhammad Imran Bhatti, Malik ZabenAbstractDecompressive craniectomy (DC) is used for the treatment of posttraumatic brain injury raised intracranial pressure. Cranioplasty is a reconstructive procedure that restores the structural integrity of the skull following (DC). Seizures are a recognised complication of cranioplasty but its incidence and risk factors in TBI patients are unclear. Accurate prognostication can help direct prophylactic and treatment strategies for seizures. In this systematic review, we aim to evaluate current literature on these factors. A PROSPERO-registered systematic review was performed in accordance with PRISMA guidelines. Data was synthesised qualitatively and quantitatively in meta-analysis where appropriate.A total of 8 relevant studies were identified, reporting 919 cranioplasty patients. Random-effects meta-analysis reveals a pooled incidence of post-cranioplasty seizures (PCS) of 5.1% (95% CI 2.6-8.2%). Identified risk factors from a single study included increasing age (OR 6.1, p = 0.006), contusion at cranioplasty location (OR 4.8, p = 0.015), and use of monopolar diathermy at cranioplasty (OR 3.5, p = 0.04). There is an association between an extended DC-cranioplasty interval and PCS risk although it did not reach statistical significance (p = 0.062).Predictive factors for PCS are poorly investigated in...

Source: Seizure - March 21, 2019 Category: Neurology Source Type: research