Analyzing Risk Factors For Epilepsy Post Traumatic Brain Injury And Post Cranioplasty

Objective:To analyze risk factors for post traumatic epilepsy(PTE) and epilepsy after cranioplasty, and to discuss the changes of incidence pre-cranioplasty and post-cranioplasty.Methods:Retrospectively analyze86cases of traumatic brain injury who took cranioplasty in our department from January2013to December2014. All the patients were divided into two groups:PTE and no PTE. Factors of gender, age, GCS(Glasgow coma scale), the severity of traumatic brain injury(diagnosed by neurologic radiography and symptoms), skull fracture, intracranial hemotoma, cerebral contusion and laceration, subdural hematoma, intracerebral hemotoma, lacerated dura, bone fragment were analysed contribution to PTE. Multivariate stepwise logistic model analysis was made after univariate analysis. Compare the incidence of epilepsy pre-cranioplasty and post-cranioplasty. Then patients were divided into several sub-groups by different factors. Analysis of epileptic incidence will be did in each sub-group.Results:Both univariate analysis and multivariate stepwise logistic model analysis showed that none of the factors analyzed were associated with posttraumatic epilepsy statistically significantly(P<0.05). Incidence of epilepsy post-cranioplasty(37%) was higher than incidence pre-cranioplasty(6.98%) statistically significantly(P<0.05). Differences of incidence for epilepsy in sub-groups of male, GCS9-12, GCS3-8, severe traumatic brain injury(diagnosed by neurologic radiography and symptoms), skull fracture, cerebral contusion and laceration, intracranial hemotoma, subdural hematoma, intracerebral hemotoma, bone fragment were statistically significantly(P<0.05), while in sub-groups of female, GCS13-15, depressed skull fracture, lacerated dura, differences of incidence for epilepsy were not statistically significantly(P>0.05).Conclusion:Each factor could not be risk factor of post traumatic epilepsy. Cranioplasty increased the incidence of post traumatic epilepsy. Especially for the sub-groups of male, GCS3-12, severe traumatic brain injury(diagnosed by neurologic radiography and symptoms), skull fracture, cerebral contusion and laceration, intracranial hemotoma, subdural hematoma, intracerebral hemotoma, bone fragment, the risk of epilepsy post cranioplasty will be increased.