破裂脳動脈瘤術後てんかんの臨床的検討

Epilepsy after Operation for Ruptured Intracranial Aneurysm

I．はじめに

　破裂脳動脈瘤術後てんかんに関する報告は比較的少ない．術後てんかんの発生頻度，発生時期，発生のriskfactor，抗てんかん剤の予防的投与の必要性を明らかにするために自験例をもとに検討し，文献的考察を加える．

Fifty-five patients who underwent surgery for rup-tured aneurysm of the anterior circulation were evalu-ated with respect to postoperative epilepsy. Prophylac-tic treatment with anticonvulsants had been carried out in all patients. The overall incidence of the postopera-tive epilepsy was 23.6% (13/55). The mean latency be-tween the operation and the first seizure was 11 months (range, 8 days to 5 years).ses were multiple aneurysms, preoperative severity, se-vere subarachnoid hemorrhage, intracerebral hemato-ma, normal pressure hydrocephalus, EEG abnormalities in the chronic stage, intracerebral low density area on CT-films and neurological deficit. Other risk factors were aneurysm of MCA and early operation for aneurysm.

The most important risk factors by statistical analy-ses were multiple aneurysms, preoperative severity, se-vere subarachnoid hemorrhage, intracerebral hemato-ma, normal pressure hydrocephalus, EEG abnormalities in the chronic stage, intracerebral low density area on CT-films and neurological deficit. Other risk factors were aneurysm of MCA and early operation for aneurysm.