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Predictors of posttraumatic convulsions in head-injured children
S K Ratan1, R Kulshreshtha, R M Pandey
1Department of Pediatric Surgery, Safdarjang Hospital, All India Institute of Medical Sciences, New Delhi, India. rmp@medinst.ernet.in
Insights
Young children and those with severe head injuries or prolonged unconsciousness are more likely to experience posttraumatic convulsions. These findings aid in predicting and managing pediatric head trauma outcomes.
Area of Science:
- Pediatric Neurology
- Trauma Care
Background:
- Head trauma is a significant cause of morbidity in children.
- Posttraumatic convulsions (PTCs) are a potential complication following pediatric head injuries, necessitating identification of predictive factors.
Purpose of the Study:
- To identify predictors of posttraumatic convulsions in children under 12 years of age admitted to Safdarjang Hospital, New Delhi.
Main Methods:
- Retrospective review of medical records of pediatric patients (under 12 years) admitted with head trauma between January and December 1997.
- Data collected included clinical, radiological, and epidemiological features.
- Occurrence of the first convulsion post-head injury was the primary outcome variable.
Main Results:
- Children younger than 2 years demonstrated a higher likelihood of PTCs (OR 2.96).
- Severe head injuries, indicated by a low Glasgow Coma Score (GCS), were significantly associated with increased risk (OR 3.07).
- A longer duration of unconsciousness, particularly exceeding 12 hours, also correlated with a higher incidence of PTCs (OR 1.71).
Conclusions:
- Age under 2 years, severity of head injury (low GCS), and prolonged unconsciousness are significant predictors of posttraumatic convulsions in children.
- Radiological findings did not show a significant association with the occurrence of posttraumatic convulsions in this cohort.
Abstract:
The purpose of this study was to determine predictors of posttraumatic convulsions in children. Study subjects included children under 12 years of age, who were admitted to the Safdarjang Hospital, New Delhi, during the year 1997 (January to December) after suffering head trauma. The occurrence of first convulsion after head injury was taken as the outcome variable in the study. Medical records were reviewed for data about clinical, radiological and epidemiological features of such children. The study revealed that children younger than 2 years of age (odds ratio, OR 2.96; 95% confidence interval, CI 1.42-6.21), those suffering severe head injuries, i.e. with low Glasgow Coma Score (OR 3.07; 95% CI 1.40-6.77), and those with longer period of unconsciousness after head trauma, especially longer than 12 h (OR 1.71; 95% CI 0.69-4.19) have higher likelihood of suffering convulsions after head injury. However, none of the radiological findings were found to be significantly associated with posttraumatic convulsions.