AIM: This study aimed to determine the frequency of traumatic brain injury (TBI) on neuroimaging and the need for emergency neurosurgery in children with normal mental status following a post-traumatic seizure (PTS).
METHODS: We searched six electronic databases from inception to 15 October 2018 to identify studies including children under 18 years with head injury and a Glasgow Coma Score of 15 after an immediate PTS. Relevant non-English articles were translated to determine eligibility.
RESULTS: We performed random effect meta-analyses and assessed heterogeneity with I2. The pooled estimate of the frequency of TBI, from seven studies, was 13.0% (95%CI 4.0-26.1; I2 =81%). Data on the need of emergency neurosurgery were reported in four studies and the pooled estimate of its frequency was 2.3% (95%CI 0.0-9.9; I2 =86%). Two studies reported on children with isolated PTS without any other signs of head injury, representing 0.1% of patients in both studies, for a total of 76 children. Of these, only three had TBI and one underwent neurosurgery.
CONCLUSION: Children with immediate PTS and normal mental status frequently have TBI with a substantial need for neurosurgery. Clinicians should strongly consider neuroimaging for these children, although prolonged observation may be considered for those with isolated PTS. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.
Language: en
Keywords
Children; Emergency department; Head trauma; Post-traumatic seizure; Traumatic brain injury