Hemorrhagic complications are uncommon after cranial epilepsy surgery, according to a study published online April 12 in World Neurosurgery.

Yong Liu, from the The First Affiliated Hospital of Xi’an Jiaotong University in China, and colleagues examined the incidence and grade of severity of hemorrhagic complications after cranial epilepsy surgery in a retrospective analysis involving patients who underwent surgery between October 2003 and April 2019.

A total of 2,026 surgical procedures were performed during the inclusion period. The researchers identified 66 hemorrhagic complications, with a total incidence of 3.3 percent. The most common types of hemorrhagic complications were epidural hemorrhage and intraparenchymal hemorrhage (57.6 and 33.3 percent, respectively). Complications were grade 1, 2, 3, and 4 in 68.2, 6.1, 24.2, and 1.5 percent of patients, respectively. Mortality due to hemorrhagic complications was 1.5 percent; among all cranial surgery, hemorrhagic mortality was 0.5 percent. A higher percentage of severe hemorrhage was induced by left versus right craniotomy (34.2 versus 14.3 percent). A higher percentage of severe hemorrhage was induced with extratemporal lobe epilepsy compared with other epilepsy types (34.2 versus 14.3 percent).

“Severe postoperative hemorrhage occurred at a low rate,” the authors write. “Although no independent risk factors for hemorrhagic complication after epilepsy surgery were identified in this study, meticulous surgical technique remains the most important approach to prevent postoperative hemorrhage.”

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