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Chapter 12 - Seizures and stroke
- from Section 1 - Clinical manifestations
- Edited by Louis R. Caplan, Jan van Gijn
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- Book:
- Stroke Syndromes, 3ed
- Published online:
- 05 August 2012
- Print publication:
- 12 July 2012, pp 158-165
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Summary
The analysis of many different studies on the characteristics of headaches provides data to help predict the type of cerebrovascular disease according to headache patterns. Lack of headache at onset, sentinel headache, or associated vomiting is predictive of ischemic stroke. A history of throbbing headache is predictive of developing headache during a stroke. A headache preceding the cerebrovascular event (sentinel headache) has been a common occurrence in most studies, reported in up to 60% of patients. The coexistence of headache and stroke encompasses a large spectrum of possibilities, including stroke caused by migraine headache, migraine developing after a stroke, and non-migraine headache occurring in relation to stroke. A higher incidence of patent foramen ovale (PFO) in migraine with aura patients suggests that cardiac microemboli affecting the vertebrobasilar circulation may participate in the migrainous mechanisms of these patients.
Contributors
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- By Pierre Amarenco, Adrià Arboix, Marcel Arnold, Robert W. Baloh, John Bamford, Jason J. S. Barton, Claudio L. Bassetti, Christopher F. Bladin, Julien Bogousslavsky, Julian Bösel, Marie-Germaine Bousser, Thomas Brandt, John C. M. Brust, Erica C. S. Camargo, Louis R. Caplan, Emmanuel Carrera, Carlo W. Cereda, Seemant Chaturvedi, Claudia Chaves, Chin-Sang Chung, Isabelle Crassard, Hans Christoph Diener, Marianne Dieterich, Ralf Dittrich, Geoffrey A. Donnan, Paul Eslinger, Conrado J. Estol, Edward Feldmann, José M. Ferro, Joseph Ghika, Daniel Hanley, Ahamad Hassan, Cathy Helgason, Argye E. Hillis, Marc Hommel, Carlos S. Kase, Julia Kejda-Scharler, Jong S. Kim, Rainer Kollmar, Joshua Kornbluth, Sandeep Kumar, Emre Kumral, Hyung Lee, Didier Leys, Eric Logigian, Mauro Manconi, Elisabeth B. Marsh, Randolph S. Marshall, Isabel P. Martins, Josep Lluís Martí-Vilalta, Heinrich P. Mattle, Jérome Mawet, Mikael Mazighi, Patrik Michel, Jay Preston Mohr, Thierry Moulin, Sandra Narayanan, Kwang-Yeol Park, Florence Pasquier, Charles Pierrot-Deseilligny, Nils Petersen, Raymond Reichwein, E. Bernd Ringelstein, Gabriel J. E. Rinkel, Elliott D. Ross, Arnaud Saj, Martin A. Samuels, Jeremy D. Schmahmann, Stefan Schwab, Florian Stögbauer, Mathias Sturzenegger, Laurent Tatu, Pariwat Thaisetthawatkul, Dagmar Timmann, Jan van Gijn, Ana Verdelho, Francois Vingerhoets, Patrik Vuilleumier, Fabrice Vuillier, Eelco F. M. Wijdicks, Shirley H. Wray, Wendy C. Ziai
- Edited by Louis R. Caplan, Jan van Gijn
-
- Book:
- Stroke Syndromes, 3ed
- Published online:
- 05 August 2012
- Print publication:
- 12 July 2012, pp vii-x
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13 - Seizures and stroke
- from PART I - CLINICAL MANIFESTATIONS
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- By Anne L. Abbott, Christopher F. Bladin, Geoffrey A. Donnan, National Stroke Research Institute, Austin,Heidelberg,Victoria, Australia
- Edited by Julien Bogousslavsky, Université de Lausanne, Switzerland, Louis R. Caplan, Harvard Medical School
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- Book:
- Stroke Syndromes
- Published online:
- 17 May 2010
- Print publication:
- 24 May 2001, pp 182-191
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Summary
Introduction
Historical references for stroke as a cause of seizures date back to Greco-Roman times when Hippocrates in 400 BC described epilepsy as a disease of the brain due to natural rather than supernatural causes. Hippocrates described older persons with paralysis following seizures consistent with seizures occurring at the onset of stroke. However, it was not until 1864 that Hughling Jackson clearly documented stroke as a cause of epilepsy. Jackson noted that ‘it is notuncommonto find when a patient has recovered or is recovering from hemiplegia, the result of embolism of the middle cerebral artery, or ofsomebranch of this vessel, that he is attacked by convulsions beginning in some part of the paralysed region’. (Taylor, 1958). Since these times it has become clear that stroke is an important cause of seizures and epilepsy, particularly in the older age group. There are, however, some important questions still to be answered.
Post stroke seizures – comparison of cerebral infarction with hemorrhage
Timing and frequency of seizures
Reports on the frequency of seizures at the onset of, and following, stroke vary quite widely because of differing stroke patient populations, sample sizes studied, follow up periods, definitions used for stroke and seizures, use of investigations such as computerized tomography (CT) and types of statistical analysis. In most studies to date the follow-up period was less than a few weeks, so the documentation of later onset or recurring seizures is limited. Studies of early and late onset poststroke seizures where patients with prestroke seizures, were largely excluded and CT was used in the diagnosis of cerebral ischemia or hemorrhage in 90% or more of patients, are summarized in Table 13.1.