Ahmed Osama, Yossri Ashour, Mohamed Negm, Hend Aboel-Hamd 

Background: Seizures are common in patients with spontaneous intracerebral hemorrhage (ICH). Understanding of the risk factors of seizures following ICH is needed to predict which patient will require treatment. Objective: To determine the factors predicting the occurrence of early post stroke seizures in patients with spontaneous ICH. Methods: Seventy patients (43 males and 27 females) with first time spontaneous ICH were included in the study. Their age ranged from 27-90 years (Mean 58.5±11.1). All the patients were subjected to clinical examination, Laboratory investigations (including early morning serum cortisol level), Computed Tomography Brain Scan at the time of admission and after 48 hours, and Electroencephalography. Patients were followed up for 7 days for the occurrence of early seizures. Results: On the follow up period, 13 patients (18.6%) developed early post stroke seizures. Four patients (30.7%) had focal seizures and 9 patients (69.3%) had generalized seizures. Patients with early post stroke seizures were significantly more likely to have Glasgow coma Scale (GCS) <12, high systolic and diastolic blood pressure, high body temperature, high random blood glucose level, lobar cortical hematoma, hematoma volume >30 cc, peri-hematoma edema, midline shift, hematoma expansion after 48 hours and periodic lateralized epileptiform discharges (PLEDs) than patients without seizures. Conclusions: GCS <12, high systolic and diastolic blood pressure, high body temperature, high random blood glucose level, lobar cortical hematoma, hematoma volume >30 cc, peri-hematoma edema, midline shift, hematoma expansion after 48 hours and PLEDs can be considered as predictors of early post stroke seizures. [Egypt J Neurol Psychiat Neurosurg.  2014; 51(1): 97-103]

 Key Words: Seizures, spontaneous intracerebral hemorrhage, Predictors