Abstract Details

Title Hemorrhagic Transformation Following Mechanical Thrombectomy in Acute Ischemic Stroke and Risk of Seizures.

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P1 - Poster Session 1 (5:30 PM-6:30 PM)

Poster/Presentation
Number 3-044

Objective To determine if hemorrhagic transformation following mechanical thrombectomy in acute ischemic stroke is a risk factor for new onset seizure.

Background About 2.3-14% of patients with ischemic stroke develop new-onset seizures regardless of treatment modality. Hemorrhagic transformation (HT) of ischemic stroke increases the risk of seizures. Reperfusion injury following mechanical thrombectomy (MT) is a well-known phenomenon that increases the risk of HT and therefore theoretically likely to increase the risk of seizures.

Design/Methods We performed a retrospective analysis of patients who presented with acute ischemic stroke (AIS) and underwent MT with or without IV TPA between January 2014 and January 2018. All patients underwent a CT scan on presentation and repeated CT scan in case of worsening symptoms. Seizures were diagnosed clinically.

Results 59 patients underwent MT (52 for anterior circulation AIS and seven posterior circulation AIS), out of which 23 patients also received TPA. Six out of 59 patients had new-onset seizures. Mean follow-up duration was 153 days. 17 out of 59 patients had HT. Three out of 17 (17.6%) patients with HT had new-onset seizures versus 3 out of 42 (7.14%) patients without HT (RR: 2.47 p:0.24). The mean duration to seizure onset was 47.7 days (IQR=8-82) with HT vs. 150 days (IQR=12-283) without HT. All six patients who had seizures had a stroke in the middle cerebral artery (MCA) territory. 3 of the six patients received TPA, one with MT and two without MT.

Conclusions Patients with HT are more likely to develop new-onset seizures without HT after mechanical thrombectomy. These results are comparable with the results published by Thevathasan et al. in 2018. Patients with HT had an earlier onset of seizures. Incidentally, all patients with seizures had MCA stroke. Larger studies are needed to confirm the conclusion with statistical significance.

Authors/Disclosures
Ahmad El Alayli, MD (Detroit Medical Canter) PRESENTER	No disclosure on file
Jay Kinariwala, MD (UNIVERSITY OF IOWA HOSPITALS AND CLINICS)	Dr. Kinariwala has nothing to disclose.
Kushak Suchdev, MD	Dr. Suchdev has nothing to disclose.
Rohit A. Marawar, MD, FAAN (Wayne State University - Detroit Medical Center)	Dr. Marawar has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Jazz Pharmaceuticals. Dr. Marawar has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for SK Pharma. Dr. Marawar has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Xenon. Dr. Marawar has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Neurelis.

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