Epilepsy after two different neurosurgical approaches to the treatment of ruptured intracranial aneurysm.

One-hundred-and-fifty-two patients who underwent surgery for intracranial aneurysm were studied to determine the incidence of postoperative epilepsy in relation to the site of the aneurysm and the type of surgical approach. The overall incidence of epilepsy was 22%. Of the 116 patients treated by the intracranial approach 27.5% developed epilepsy, in contrast with only 5% of the 36 patients who had carotid artery ligation in the neck. Epilepsy occurred most frequently (35%) with middle cerebral artery aneurysms, especially if moderate or severe operative trauma was sustained and there was postoperative dysphasia.