The cortical involvement of territorial infarcts as a risk factor for stroke-related seizures.
BACKGROUND
The cortical involvement of territorial infarcts is considered to be a significant risk factor for the development of early- as well as late-onset seizures. However, it is not known which cortical regions are more susceptible to the development of stroke-related seizures.


METHODS
In this retrospective study of 687 patients with territorial infarcts, 184 with stroke-related seizures were compared to 503 without seizures. The extent and the location of the infarcts were determined by computed tomography (CT) scans and/or magnetic resonance imaging (MRI) scans of the brain. The infarcts of the seizure and the non-seizure group were compared on digital cerebral vascular maps by superimposing the CT and/or MRI slices.


RESULTS
In patients with late-onset seizures, the infarcts were significantly more frequent in the temporal and parietal branches of the middle cerebral artery in comparison to the non-seizure group. In patients with early-onset seizures and in those with seizures due to a recurrent stroke, the territory of the temporal and occipital branches of the middle cerebral artery was the predilection side of the infarcts. Generalized tonic-clonic seizures occurred mainly in cases of infarction in the deep territory of the middle cerebral and of the anterior choroidal artery. Status epilepticus was significantly correlated with infarcts in the posterior temporal region.


CONCLUSIONS
Some infarct regions are the sides of predilection for stroke-related seizures according to their type and their onset-time.
De Reuck
J
J
Stroke Unit, Department of Neurology, University Hospital, Ghent, Belgium. dereuck.j@gmail.com
De Groote
L
L
Van Maele
G
G
Proot
P
P
D000368:Aged; D000369:Aged, 80 and over; D002540:Cerebral Cortex; D002560:Cerebrovascular Circulation / Q000502:physiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D012640:Seizures / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D020521:Stroke / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology*; D013997:Time Factors