• Joshua L Goldstein, Daniel Leonhardt, Natalie Kmytyuk, Francine Kim, Deli Wang, and Mark S Wainwright.
• Division of Neurology no. 51, Department of Pediatrics, Children's Memorial Hospital, Northwestern University Feinberg School of Medicine, 2300 Children's Plaza, Chicago, IL 60614, USA. jgoldstein@childrensmemorial.org
• Neurocrit Care. 2011 Aug 1;15(1):63-9.

BackgroundAbusive head trauma (AHT) is a common condition in children. Little is known in this condition regarding the frequency of seizures, the factors associated with increased risk of seizures, or the association of seizures with outcome. We sought to determine frequency and risks for in-hospital seizures after AHT.MethodsThis was a single-center, retrospective chart review study at a 270 bed tertiary care referral pediatric hospital.ResultsA total of 54 cases of AHT were identified during the study period. During the first week following hospital admission, 33% of patients were observed to have clinical seizures. The occurrence of clinical seizures after admission was associated with findings on initial CT including midline shift, cerebral edema, and loss of gray white differentiation. MRI findings associated with clinical seizures after admission included midline shift, cerebral edema, infarction, and restricted diffusion. The presenting complaint of seizures or acute mental status changes well as a variety of abnormal imaging findings including gray white blurring, infarction, and edema were associated with short-term outcomes.ConclusionsSpecific neuroradiologic findings identify children at greater risk for seizures, both clinical and subclinical, following AHT. Clinical and subclinical seizures are common in the initial hospitalization for AHT.

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