Temkin identified risk factors for posttraumatic seizures in an adult with traumatic brain injury (TBI). This can help to identify a patient who may benefit from more aggressive management. The author is from the University of Washington in Seattle.
Patient selection: traumatic brain injury (TBI)
Risk factors for posttraumatic seizures from multivariate analysis:
(1) early seizures (within 7 days of event)
(2) duration of coma (time between TBI and ability to follow commands) >= 1 week
(3) dural penetration during traumatic event
(4) depressed skull fracture not surgically elevated
(5) >= 1 nonreactive pupil
Other risk factors:
(1) removal of a subdural and/or intracerebral hematoma
(2) Glasgow coma scale from 3 to 8
(3) parietal lesion on brain CT scan
(4) posttraumatic amnesia > 24 hours
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