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Related Experiment Videos

Immediate posttraumatic seizures: is routine hospitalization necessary?

M S Dias1, F Carnevale, V Li

  • 1Department of Neurosurgery, Children's Hospital of Buffalo, State University of New York at Buffalo, NY 14222, USA. mdias@chob.edu

Pediatric Neurosurgery
|August 26, 1999
PubMed
Summary
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Children with minor head injuries and simple posttraumatic seizures (PTS) may be safely discharged from the emergency room if they meet specific criteria. This approach could reduce hospital admissions for these patients.

Area of Science:

  • Pediatric Neurology
  • Emergency Medicine
  • Neurosurgery

Background:

  • Pediatric neurosurgeons often admit children with posttraumatic seizures (PTS) for observation.
  • An estimated 86% of pediatric neurosurgeons routinely admit these patients.
  • This practice leads to unnecessary hospitalizations and costs.

Purpose of the Study:

  • To determine if children with minor head injuries and simple PTS can be safely discharged from the emergency room.
  • To identify criteria for safe discharge of pediatric patients with PTS.
  • To reduce unnecessary hospital admissions and healthcare costs.

Main Methods:

  • Retrospective review of 71 children admitted with seizure and head injury over 5 years.
  • Inclusion criteria: minor head injury, PTS within 24 hours, normal admission CT scan.

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  • Exclusion criteria: prior neurological conditions, prior seizures, prior anticonvulsant use, intracranial abnormalities.

    • Main Results:

    • Of 71 children, 11 required ICU admission due to prolonged seizures, apnea, or low GCS.
    • The remaining 60 children with simple PTS had no further seizures or complications.
    • Average hospital cost for non-ICU patients was $1,615.

    Conclusions:

    • Children with isolated minor head injuries and simple PTS, normal CT scans, and no prior neurological history are at low risk for recurrence.
    • These patients may be safely discharged to a reliable caretaker.
    • Larger studies are needed to confirm these findings and establish a standard policy.