INTRODUCTION: Seizures are common after intracerebral haemorrhage. Tranexamic 
acid increases the risk of seizures in non-intracerebral haemorrhage population 
but its effect on post-intracerebral haemorrhage seizures is unknown. We 
explored the risk factors and outcomes of seizures after intracerebral 
haemorrhage and if tranexamic acid increased the risk of seizures in the 
Tranexamic acid for IntraCerebral Haemorrhage-2 trial.
PATIENTS AND METHODS: Seizures were reported prospectively up to day 90. Cox 
regression analyses were used to determine the predictors of seizures within 
90 days and early seizures (≤7 days). We explored the effect of early seizures 
on day 90 outcomes.
RESULTS: Of 2325 patients recruited, 193 (8.3%) had seizures including 163 
(84.5%) early seizures and 30 (15.5%) late seizures (>7 days). Younger age 
(adjusted hazard ratio (aHR) 0.98 per year increase, 95% confidence interval 
(CI) 0.97-0.99; p = 0.008), lobar haematoma (aHR 5.84, 95%CI 3.58-9.52; 
p < 0.001), higher National Institute of Health Stroke Scale (aHR 1.03, 95%CI 
1.01-1.06; p = 0.014) and previous stroke (aHR 1.66, 95%CI 1.11-2.47; p = 0.013) 
were associated with early seizures. Tranexamic acid did not increase the risk 
of seizure within 90 days. Early seizures were associated with worse modified 
Rankin Scale (adjusted odds ratio (aOR) 1.79, 95%CI 1.12-2.86, p = 0.015) and 
increased risk of death (aOR 3.26, 95%CI 1.98-5.39; p < 0.001) at day 
90.Discussion and conclusion: Lobar haematoma was the strongest independent 
predictor of early seizures after intracerebral haemorrhage. Tranexamic acid did 
not increase the risk of post-intracerebral haemorrhage seizures in the first 
90 days. Early seizures resulted in worse functional outcome and increased risk 
of death.