SAFETYLIT WEEKLY UPDATE

We compile citations and summaries of about 400 new articles every week.
Email Signup | RSS Feed

HELP: Tutorials | FAQ
CONTACT US: Contact info

Search Results

Journal Article

Citation

Dingman AL, Stence NV, O'Neill BR, Sillau SH, Chapman KE. Pediatr. Neurol. 2018; 82: 29-35.

Affiliation

Department of Pediatrics, Division of Child Neurology, University of Colorado Anschuts Medical Campus, Aurora, Colorado.

Copyright

(Copyright © 2018, Elsevier Publishing)

DOI

10.1016/j.pediatrneurol.2017.12.003

PMID

29625848

Abstract

BACKGROUND: The objective of this study was to characterize hypoxic-ischemic injury and seizures in abusive head trauma.

METHODS: We performed a retrospective study of 58 children with moderate or severe traumatic brain injury due to abusive head trauma. Continuous electroencephalograms and magnetic resonance images were scored.

RESULTS: Electrographic seizures (51.2%) and hypoxic-ischemic injury (77.4%) were common in our cohort. Younger age was associated with electrographic seizures (no seizures: median age 13.5 months, interquartile range five to 25 months, versus seizures: 4.5 months, interquartile range 3 to 9.5 months; P = 0.001). Severity of hypoxic-ischemic injury was also associated with seizures (no seizures: median injury score 1.0, interquartile range 0 to 3, versus seizures: 4.5, interquartile range 3 to 8; P = 0.01), but traumatic injury severity was not associated with seizures (no seizures: mean injury score 3.78 ± 1.68 versus seizures: mean injury score 3.83 ± 0.95, P = 0.89). There was a correlation between hypoxic-ischemic injury severity and seizure burden when controlling for patient age (rs=0.61, P < 0.001). The ratio of restricted diffusion volume to total brain volume (restricted diffusion ratio) was smaller on magnetic resonance imaging done early (median restricted diffusion ratio 0.03, interquartile range 0 to 0.23 on magnetic resonance imaging done within two days versus median restricted diffusion ratio 0.13, interquartile range 0.01 to 0.43 on magnetic resonance imaging done after two days, P = 0.03).

CONCLUSIONS: Electrographic seizures are common in children with moderate to severe traumatic brain injury from abusive head trauma, and therefore children with suspected abusive head trauma should be monitored with continuous electroencephalogram. Severity of hypoxic-ischemic brain injury is correlated with severity of seizures, and evidence of hypoxic-ischemic injury on magnetic resonance imaging may evolve over time. Therefore children with a high seizure burden should be reimaged to evaluate for evolving hypoxic-ischemic injury.

Published by Elsevier Inc.


Language: en

Keywords

Abusive head trauma; Acute seizures; Hypoxic-ischemic injury; Status epilepticus; Traumatic brain injury

NEW SEARCH


All SafetyLit records are available for automatic download to Zotero & Mendeley
Print