• Medientyp: E-Artikel
  • Titel: Clinical Relevance of Seizure in Pediatric Patients with Isolated Acute Subdural Hematoma without Parenchymal Brain Injury
  • Beteiligte: Won, Sae-Yeon; Dubinski, Daniel; Behmanesh, Bedjan; Strzelczyk, Adam; Seifert, Volker; Konczalla, Juergen; Freiman, Thomas M.
  • Erschienen: Georg Thieme Verlag KG, 2019
  • Erschienen in: Journal of Neurological Surgery Part A: Central European Neurosurgery, 80 (2019) 4, Seite 233-239
  • Sprache: Englisch
  • DOI: 10.1055/s-0039-1677824
  • ISSN: 2193-6323; 2193-6315
  • Schlagwörter: Neurology (clinical) ; Surgery
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  • Beschreibung: Purpose Isolated acute subdural hematoma (aSDH) in pediatric patients is rare, but it has a major impact on outcome. The purpose of this study was to determine incidence, seizure risk factors, and the outcome of pediatric patients with aSDH. Methods Within a 10-year period (2007–2016), 10 children with aSDH were identified. Baseline characteristics and these parameters were analyzed: pediatric Glasgow Coma Scale (pGCS) score at admission and 24 hours after the operation, hematoma volume/side, and midline shift. Functional outcome was assessed at 3-month follow-up using the King's Outcome Scale for Childhood Head Injury score. Results Three subgroups were identified depending on age and etiology: birth-associated, nontraumatic, and traumatic aSDH. The overall incidence of seizures was 60%, and an even higher rate (75%) was observed in children < 1 month of age. Of those patients, two (67%) developed late seizures. Significant predictors for seizures were low pGCS score at admission (p = 0.03) and 24 hours after surgery (p = 0.03) as well as increased midline shift (p = 0.02). Patients with seizures tended to have an unfavorable outcome. Conclusion Pediatric patients with aSDH are at high risk for seizures, particularly if the pGCS score is low at admission/24 hours after the operation and midline shows a shift. Determining seizure-prone pediatric patients may facilitate early antiepileptic treatment and promote better clinical outcomes.