Department of Neurosurgery, Hallym University College of Medicine, Chuncheon, Korea.
Institute of New Frontier Stroke Research, Hallym University College of Medicine, Chuncheon, Korea.
J Chin Med Assoc. 2020 May;83(5):466-470. doi: 10.1097/JCMA.0000000000000293.
To provide updated information on seizure events and patterns in patients with angiogram-negative subarachnoid hemorrhage based on the initial hemorrhage patterns: perimesencephalic subarachnoid hemorrhage (PMH) vs non-PMH.
A review of online database literature from January 1990 to November 2017 was systematically performed. In case of heterogeneity <50%, a fixed effect model was used. Publication bias was determined using Begg funnel plot and the trim-and-fill method.
A total of 9 studies with 645 patients were included for final analysis after excluding one study without any seizure within either cohort. PMH patients had lower seizure rates (odds ratio, 0.393; 95% CI, 0.158-0.978) compared with non-PMH patients. The funnel plot showed a relatively asymmetric pattern, suggesting possible publication bias. After correction of the forest plot, the adjusted odds ratio was 0.362 (95% CI, 0.148-0.886), indicating significant relationships between PMH and lower incidence of seizure.
PMH is associated with lower seizure risk than non-PMH. However, possible publication bias could be a concern to the interpretation. Additional meta-analyses based on individual patient data from prospective large-scale studies are necessary.
根据初始出血模式（间脑周围型蛛网膜下腔出血[PMH]与非-PMH），提供血管造影阴性蛛网膜下腔出血患者的癫痫发作事件和模式的最新信息。
系统地对 1990 年 1 月至 2017 年 11 月在线数据库文献进行了回顾。如果异质性<50%，则使用固定效应模型。使用 Begg 漏斗图和填充法确定发表偏倚。
排除了一项两个队列均无癫痫发作的研究后，共有 9 项研究（共 645 例患者）纳入最终分析。与非-PMH 患者相比，PMH 患者的癫痫发作率较低（优势比，0.393；95%置信区间，0.158-0.978）。漏斗图显示出相对不对称的模式，表明可能存在发表偏倚。校正森林图后，调整后的优势比为 0.362（95%置信区间，0.148-0.886），表明 PMH 与较低的癫痫发作发生率之间存在显著关系。
PMH 与较低的癫痫发作风险相关。然而，可能存在发表偏倚，这可能影响解释。需要基于前瞻性大规模研究的个体患者数据进行进一步的荟萃分析。
