Document Detail

Watershed infarctions are more prone than other cortical infarcts to cause early-onset seizures.
MedLine Citation:
PMID:  20937949     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Early-onset seizures(ESs) have been reported in 2% to 6% of strokes. Most previous studies have been retrospective and did not systematically perform cerebral magnetic resonance imaging (MRI). OBJECTIVE: To determine the prevalence and determinants of ESs in a prospective cohort. DESIGN: Prospective cohort study. SETTING: Stroke unit in an academic hospital. PATIENTS: Six hundred sixty-one consecutive individuals admitted to our stroke unit during an 18-month period for suspected stroke. MAIN OUTCOME MEASURES: Initial investigations systematically included cerebral MRI. Among patients with MRI-confirmed cerebral infarction, individuals with ES, defined as occurring within 14 days of stroke, were identified. RESULTS: Three hundred twenty-eight patients had MRI-confirmed cerebral infarcts and 178 had cortical involvement. The ESs, all initially partial seizures, occurred in 14 patients (4.3%) and at stroke onset in 5 patients. The ESs occurred exclusively in patients with cortical involvement (P <.001). With infarcts involving the cerebral cortex, there was a higher risk of ESs in watershed infarctions than in territorial strokes (6 of 26 [23.1%] vs 8 of 152 [5.3%], P = .007). Logistic regression analysis showed an almost 4-fold increased risk of ES in patients with watershed infarctions compared with other cortical infarcts (odds ratio, 4.7; 95% confidence interval, 1.5- 15.4; P = .01). Age, sex, diabetes mellitus, hypertension, smoking, National Institutes of Health Stroke Scale score, and cardioembolic origin were not significant risk factors for ES. CONCLUSIONS: The cortical hemispheric location of ischemic strokes is associated with a higher risk of ES. Among these patients, the watershed mechanism is a strong and independent determinant of stroke-related ES.
Christian Denier; Pascal Masnou; Yacouba Mapoure; Raphaelle Souillard-Scemama; Thierry Guedj; Marie Théaudin; Ombeline Fagniez; Claire Join-Lambert; Pierre Lozeron; Béatrice Ducot; Denis Ducreux; David Adams
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of neurology     Volume:  67     ISSN:  1538-3687     ISO Abbreviation:  Arch. Neurol.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-12     Completed Date:  2010-10-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372436     Medline TA:  Arch Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1219-23     Citation Subset:  AIM; IM    
Department of Neurology, Centre Hospitalo-Universitaire de Bicêtre, 94275 Le Kremlin-Bicêtre Cedex, France.
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MeSH Terms
Cerebral Infarction / complications*
Cohort Studies
Magnetic Resonance Imaging / methods
Middle Aged
Retrospective Studies
Risk Factors
Seizures / etiology*
Stroke / complications*,  pathology*
Young Adult

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