Seizures Following Cranioplasty: Risk Factors and Prevention Exploration

Background: The aim of this study was to identify risk factors and explore the possible prevention measures for seizures following cranioplasty. Methods: The authors performed a retrospective review of 142 consecutive patients who underwent cranioplasty following craniectomy for trauma or cerebral hemorrhage in Dezhou People's Hospital between January 2010 and January 2017. Patients who were diagnosed with aneurysms, arteriovenous malformations, cerebral infarction, and tumors (14), had seizures prior to cranioplasty (9) and those lost to follow-up (7) were excluded. Patients did not use antiepilepsy drugs from treatment of postcranioplasty seizures. The median follow-up time was 51.11 ± 31.59 months (range: 17–98 months). Analyses were performed on a database tracking age, sex, reason for craniectomy, operative time, time between operations, presence of dural substitute, diabetic status, hypertensive status, tobacco use, alcohol use, location of cranioplasty, classification, time and times of seizures following cranioplasty development. Results: One hundred twelve patients met study criteria. The overall rate of seizures following cranioplasty was 35.7% (40 out of 112 patients). There were no statistically significant associations between postcranioplasty seizures and sex, age, location of cranioplasty, cranioplasty materials, or dural substitute used in craniectomy. Postcranioplasty seizure frequency differed significantly according to reasons for depressive craniectomy. The incidence of postcranioplasty seizures was significantly higher in the first year than in later years. Incidence decreased progressively in subsequent years. Conclusion: Incidence of seizures following cranioplasty was associated with the reason for depressive craniectomy. Address correspondence and reprint requests to Gang Li, MD, Department of Neurosurgery, Qi Lu Hospital, Shandong University, 107#, Wenhua Xi Road, Jinan 250012, China; E-mail: doctorligang1@126.com Received 24 February, 2018 Accepted 22 September, 2018 The authors report no conflicts of interest. © 2019 by Mutaz B. Habal, MD.

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