| Epilepsy after bypass surgery in adult moyamoya disease. | |
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MedLine Citation:
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PMID: 21273919 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND:: Postoperative seizure, well-known for other pathologies, has been rarely discussed in adult moyamoya disease. OBJECTIVE:: We evaluated postoperative seizures in adult moyamoya patients undergoing revascularization surgery. METHODS:: From 2001 to 2007, 43 adult moyamoya patients underwent 53 revascularization surgeries, consisting of direct with or without indirect bypass. Incidence and profile of postoperative seizures were investigated, with evaluation of influencing factors. Multivariable analysis using generalized estimation equation (GEE) was performed to determine influencing factors for postoperative seizure. RESULTS:: Seizures developed in 10 sides (18.9 %) after revascularization of moyamoya disease, including immediate (< 24 hours, n = 0), early (1-7 days, n = 5), late (8-30 days, n = 0), and delayed seizures (≥ 1 months, n = 7). Early and subsequent delayed seizures developed in the same lesions in two patients. Seizures developed only in the patients with combined direct and indirect revascularization. Postoperative temporary neurological deficits with image abnormalities were significantly related with postoperative non-delayed seizures (P=0.020). Delayed seizures were significantly different according to the location of the recipient artery (P=0.034), especially with the frontal branches. By multivariable analysis, revascularization using frontal branches trended toward increased incidence of delayed postoperative seizure, with adjusted OR of 13.78 (95% confidential interval 1.7- 114.1). CONCLUSION:: In adult moyamoya patients, the incidence of delayed postoperative seizure seems to be higher than other pathologies. The delayed, pronounced formation of synangiosis in moyamoya disease may have a relationship with the development of such delayed postoperative seizures, especially when the location of the recipient artery is frontal. |
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Authors:
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Sung-Chul Jin; Changwan Oh; O-Ki Kwon; Gyojun Whang; Jae Seung Bang; Hyun-Seung Kang; Jeong Eun Kim; Sang Hyung Lee; Young-Seob Chung |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-1-26 |
Journal Detail:
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Title: Neurosurgery Volume: - ISSN: 1524-4040 ISO Abbreviation: - Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2011-1-28 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7802914 Medline TA: Neurosurgery Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea; Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea; *Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea; **Department of Neurosurgery, Seoul National University Boramae Hospital, Seoul, Korea. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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