12/8/2022 0 Comments Future never end remix download![]() Both ICD codes and ICD for Oncology (ICD-O) codes are available, and therefore histological information is available for all surgically treated neurological tumours. The Danish Cancer Registry 10 contains information on cancer diagnoses in Denmark since 1943. Diagnoses given by general practitioners and private specialist clinics are not available from the NPR. The National Patient Register (NPR) 9 covers all hospital admittances and discharge diagnoses since 1977 furthermore, since 1995 it also includes emergency room visits, outpatient contacts and surgeries, providing information on diseases according to the International Classification of Diseases (ICD) and surgeries according to Nordic Medico-Statistical Committee Classification of Surgical Procedures. All individuals are given a unique social security number allowing for linkages between registers. The Civil Registration System (CRS) 8 contains demographic information on every individual living in Denmark since 1968. Moreover, we estimated the cumulative risks for subgroups of craniotomy indications, where in most, the risk of postoperative de novo epilepsy is hitherto unknown. The aim of this study was therefore to investigate the cumulative risk of postoperative de novo epilepsy in craniotomy patients in a nationwide, unselected cohort, encompassing all patients who underwent a craniotomy in Denmark during 2005–2015. ![]() Studies specifically investigating the risk of epilepsy following a craniotomy in patients without preoperative epilepsy are very scarce, nevertheless, it is highly relevant to investigate these risks from both a clinical and society perspective. 6 A much higher risk of 59% of de novo epilepsy within 27 months after craniotomy was reported among 141 patients with the highly malignant glioblastoma multiforme, 5 which suggests high variability according to subtypes of indication. These coexisting effects are illustrated by a Swedish study of 113 meningioma patients with at least 7 years of follow-up, reporting that eight of the 21 patients with preoperative epilepsy were free of epilepsy after the surgery (38%), whereas 13 of the remaining 92 patients without preoperative epilepsy developed postoperative de novo epilepsy(14%). At the same time preoperative epilepsy may be reduced by removal of a mass lesion. Due to the inevitable cortical trauma, gliosis, and changes in microcirculation following a craniotomy, it is reasonable to believe that the procedure may carry a risk of de novo epilepsy. 2–7 A craniotomy is a surgical procedure with removal of an intracranial mass lesion or closure of vascular anomalies through an opening of the skull. The major indications for craniotomy, being intracranial tumour, spontaneous or traumatic haemorrhage, or intracerebral abscess, will in themselves constitute a significant risk of epilepsy (5%–35%). ![]() Like in many other countries, prophylactic antiepileptic medicine or driving restrictions in relation to craniotomy is not used in Denmark Guidelines and recommendations regarding these matters are highly variable between countries due to the hitherto scarce investigations of the risk of postoperative de novo epilepsy after a craniotomy. The risk of de novo epilepsy is of relevance to the question of prophylactic antiepileptic treatment and driving restrictions following craniotomy, as well as the general disease burden associated with having epilepsy. In 1996, the American neurosurgeon Vertosick wrote: ‘You ain’t never the same when the air hits your brain’, 1 this being well exemplified by the known acute and long-term complication of postoperative de novo epilepsy after craniotomy.
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