Neurocritical Care

, Volume 30, Issue 1, pp 16–21 | Cite as

Non-electrographic Seizures Due to Subdural Hematoma: A Case Series and Review of the Literature

  • Joseph Driver
  • Aislyn C. DiRisio
  • Heidi Mitchell
  • Zachary D. Threlkeld
  • William B. GormleyEmail author
Review Article


Seizures due to subdural hematoma (SDH) are a common finding, typically diagnosed using electroencephalography (EEG). At times, aggressive management of seizures is necessary to improve neurologic recovery and outcomes. Here, we present three patients who had undergone emergent SDH evacuation and showed postoperative focal deficits without accompanying electrographic epileptiform activity. After infarction and recurrent hemorrhage were ruled out, seizures were suspected despite a negative EEG. Patients were treated aggressively with AEDs and eventually showed clinical improvement. Long-term monitoring with EEG revealed electrographic seizures in a delayed fashion. EEG recordings are an important tool for seizure detection, but should be used as an adjunct to, rather than a replacement for, the clinical examination in the acute setting. At times, aggressive treatment of suspected postoperative seizures is warranted despite lack of corresponding electrographic activity and can improve clinical outcomes.


Seizures Intensive care Subdural hematoma 


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Joseph Driver
    • 1
  • Aislyn C. DiRisio
    • 1
  • Heidi Mitchell
    • 2
  • Zachary D. Threlkeld
    • 3
  • William B. Gormley
    • 1
    Email author
  1. 1.Department of NeurosurgeryBrigham and Women’s HospitalBostonUSA
  2. 2.Massachusetts General Hospital Institute of Health ProfessionsBostonUSA
  3. 3.Department of Neurology, Massachusetts General Hospital and Brigham and Women’s HospitalHarvard Medical SchoolBostonUSA

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