• Yong Liu, Jiale Zhang, Yutao Ren, Hao Wu, Huanfa Li, Changwang Du, Qiang Meng, Hua Zhang, and Maode Wang.
• Department of Neurosurgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
• World Neurosurg. 2024 Jul 1; 187: e122e128e122-e128.

BackgroundSurgery is effective in the treatment of epilepsy, particularly focal epilepsy. The aim of this work was to report the incidence and grade of severity of hemorrhagic complications after cranial epilepsy surgery, and investigate the risk factors.MethodsPatients who underwent epilepsy surgery via craniotomy between October 2003 and April 2019 were retrospectively analyzed. The incidence of hemorrhagic complications occurring in a 3-month period after cranial surgery was recorded. Other outcomes included the grade of hemorrhagic severity and risk factors.ResultsDuring the inclusion period, 2026 surgical procedures were performed. Sixty-six hemorrhagic complications were recorded. The total incidence of hemorrhagic complications after cranial epilepsy surgery was 3.3%. The most common type of hemorrhagic complications was epidural hemorrhage (57.6%), followed by intraparenchymal hemorrhage (33.3%). Forty-five patients (68.2%) had grade I complications, 4 (6.1%) grade II, 16 (24.2%) grade III, and 1 (1.5%) grade IV. The mortality due to hemorrhagic complications was 1.5% (1 of 66) and hemorrhagic mortality among all cranial surgery was 0.05% (1 of 2026). Left craniotomy induced a higher percentage of severe hemorrhage than the right (34.2% vs. 14.3%). Extratemporal lobe epilepsy induced a higher percentage of severe hemorrhage than other epilepsy type (34.2% vs. 14.3%). However, no statistically significant difference was observed between these two factors (P = 0.067).ConclusionsHemorrhagic complications were uncommon after open surgery for epilepsy. Most hemorrhagic complications were mild while the severe were rare. Patients with hemorrhagic complications had a good prognosis after effective treatment.Copyright © 2024 Elsevier Inc. All rights reserved.

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