Risk factors for seizures after intracerebral hemorrhage: Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) Study

Academic Article


  • Objective: We aimed to identify risk factors for seizures after intracerebral hemorrhage, and to validate the prognostic value of the previously reported CAVE score (0–4 points: cortical involvement, age <65, volume >10 mL, and early seizures within 7 days of hemorrhage). Patients and methods: Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) was a prospective study of spontaneous intracerebral hemorrhage. We included patients who did not have a prior history of seizure and survived to discharge. Univariate analysis and multiple logistic regression modeling were used to identify risk factors for seizure. Results: From 2010–2015, 3000 cases were recruited, and 2507 patients were included in this study. Seizures after hospital discharge developed in 77 patients 3.1 %). Patients with lobar (cortical) hemorrhage (OR 3.0, 95 % CI 1.8–5.0), larger hematoma volume (OR 1.5 per cm3, 95 % CI 1.2–2.0), and surgical evacuation of hematoma (OR 2.6, 95 % CI 1.4–4.8) had a higher risk of late seizure, and older patients had a lower risk (OR 0.88 per 5-year interval increase, 95 % CI 0.81–0.95). The CAVE score was highly associated with seizure development (OR 2.5 per unit score increase, 95 % CI 2.0–3.2, p < 0.0001). The CAVS score, substituting surgical evacuation for early seizure, increased the OR per unit score to 2.8 (95 % CI 2.2–3.5). Conclusions: Lobar hemorrhage, larger hematoma volume, younger age, and surgical evacuation are strongly associated with the development of seizures. We validated the CAVE score in a multi-ethnic population, and found the CAVS score to have similar predictive value while representing the current practice of AED use.
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    Digital Object Identifier (doi)

    Pubmed Id

  • 26818573
  • Author List

  • Kwon SY; Obeidat AZ; Sekar P; Moomaw CJ; Osborne J; Testai FD; Koch S; Lowe MR; Demel S; Coleman ER
  • Volume

  • 192