Neurological Surgery No Shinkei Geka Volume 45, Issue 4 (April 2017)

Hemodialysis Increases the Incidence of Post-Traumatic Seizure in Hemodialysis Patients with Traumatic Intracranial Hemorrhage Tomoya OISHI 1 , Seiya TAKEHARA 1 , Yasuhiro YAMAMURA 1 , Mamoru TOMIDA 1 , Naoki IKEGAYA 2 , George SEKI 3 , Nobutaka OHTA 4 1Department of Neurosurgery, Yaizu Municipal Hospital 2Department of Internal Medicine, Yaizu Municipal Hospital 3Department of Nephrology, Yaizu Municipal Hospital 4Department of Urology, Yaizu Municipal Hospital Keyword: traumatic head injury , hemodialysis , seizure , disequilibrium syndrome pp.303-309
Published Date 2017/4/10
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 BACKGROUND:In Japan, the number of hemodialysis patients increases every year, along with the average age of this patient population. Further, certain complications of hemodialysis make the care of traumatic head injury(THI)patients particularly difficult.

 OBJECTIVE:This study was aimed at investigating the occurrence of and risk factors for post-traumatic seizures in hemodialysis patients with a history of THI, and determining patient outcomes.

 METHODS:Subjects were selected from patients who were admitted to Yaizu Municipal Hospital in Shizuoka, Japan for traumatic intracranial hemorrhage(TICH). Retrospective medical histories of TICH patients who were and were not receiving hemodialysis were reviewed to investigate the risk factors for seizures and to determine patient outcomes.

 RESULTS:We identified 18 THI patients on hemodialysis and 86 THI patients not on hemodialysis treatment. We determined that predictive factors of post-traumatic seizure include:current hemodialysis treatment, enlargement of an existing hematoma, and an acute subdural hematoma. Moreover, 66.7% of seizures in our dialysis patients occurred during hemodialysis. Our data also suggest that Glasgow Coma Scale(GCS)scores on admission are a predictive factor for patient outcomes following discharge.

 CONCLUSION:Current hemodialysis treatment, enlargement of an existing hematoma, and an acute subdural hematoma are predictive factors of seizure occurrence in THI patients. As post-traumatic seizures triggered unfavorable outcomes in some dialysis patients, it is important to create appropriate plans for preventing dialysis disequilibrium syndrome that may lead to seizures in TICH/TIH patients on hemodialysis. We also determined that a low GCS score upon admission is a significant predictor of unfavorable outcomes.

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Neurological Surgery 脳神経外科
45巻4号 (2017年4月)
電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院