Analysis Of Risk Factors Of Late Epilepsy After Craniocerebral Trauma

Purpose: To analyze the correlation of age,sex,GCS score,severity of craniocerebral trauma,type of craniocerebral injury,skull repair and repair materials with late epilepsy after craniocerebral trauma,study on risk factors of Secondary late Epilepsy after craniocerebral Trauma.Method:432 cases of head trauma from January 2016 to January 2017 were analyzed retrospectively,and the relevant information of each patient was filled into the corresponding Excel form according to the medical record data during the hospitalization of the patient,and the relevant information of each patient was filled into the corresponding Excel form in combination with the follow-up.According to whether the late-stage epilepsy is divided into the epilepsy group and the non-epileptic group after the craniocerebral trauma;according to the sex of the patients,they were divided into two groups: male and female,and according to the severity of craniocerebral injury,they were divided into three groups: mild,moderate and severe;according to whether there are brain bruises,concave skull fractures and intracranial hematoma after craniocerebral injury,we divide them into groups;according to whether the skull repair was performed and the repair material was an autologous bone or a titanium mesh.A 1-year follow-up study was performed on all patients with head injury,and the correlation of the post-traumatic epilepsy was analyzed from the aspects of sex,age,GCS score,type of head injury,severity of head injury,skull repair,and repair material.And analysis and comparison of the type of attack and the manifestation of the electroencephalogram of the second-stage epilepsy after the head injury.The incidence of epilepsy in each group and each subgroup was compared,and the correlation of the factors with the secondary late-stage epilepsy following the head injury was analyzed.Result: There were 432 cases of craniocerebral trauma and 90 cases of cranioplasty,of which 45 cases developed epilepsy after operation,another case had epilepsy one week after brain injury and before cranioplasty,and the severity and frequency of seizure increased significantly after craniocerebral trauma.There were 47 patients with secondary epilepsy or exacerbation after skull repair,accounting for 52.22% of the patients who underwent cranioplasty in the same period.Of the 60 cases with autogenous bone repair,32 cases were secondary late epilepsy,accounting for 53.33%;of the patients undergoing autogenous bone repair,and 15 cases were secondary late epilepsy,accounting for 50% of the patients who underwent titanium mesh repair.This group of 52 cases of secondary late epilepsy,accounting for 12.04% of the patients with craniocerebral trauma in the same period.Among them,41 cases were male and 11 cases were female,45 cases were < 18 years old,7 cases were over 18 years old,38 cases were brain bruise,48 cases were intracranial hematoma,29 cases were skull fracture.According to GCS score,there were 11 cases with 13-15 points,12 cases with 9-12 points,29 cases with 3-8 points,according to the severity of craniocerebral injury: 2 cases with mild craniocerebral injury,13 cases with moderate craniocerebral injury and 37 cases with severe craniocerebral injury.There were 17 cases with partial seizures,13 cases with secondary generalized seizures and 22 cases with generalized seizures.Univariate analysis,age,GCS score,brain trauma,intracranial hematoma,severity of brain injury,skull repair,repair materials and late epilepsy after craniocerebral trauma had statistical significance(P < 0.05).There was no significant difference in the occurrence of late epilepsy after craniocerebral trauma between skull fracture and prophylaxis(P > 0.05).Logistics regression analysis showed that there was significant difference between age and late epilepsy after craniocerebral trauma(P < 0.05).The severity of craniocerebral injury was significantly different from that of late epilepsy after craniocerebral trauma(P < 0.05),and the difference between cranioplasty and late epilepsy after craniocerebral trauma was statistically significant(P < 0.05).There was significant difference between GCS score and late epilepsy after craniocerebral trauma(P< 0.05),and there was significant difference between intracranial hematoma and late epilepsy after craniocerebral trauma(P<0.05).There was no significant difference in the occurrence of late epilepsy between contusion and laceration of brain,skull repair material and late epilepsy after craniocerebral trauma(P > 0.05).Conclusion: Age,GCS score,severity of craniocerebral trauma,intracranial hematoma and skull repair are the risk factors of late epilepsy after craniocerebral trauma,and the prognosis can be improved by appropriate intervention according to the above risk factors.