Brain Injury and Post-traumatic Seizures

 

  • patients with head injury are at an increased risk for post-traumatic seizures

 

Classified as:

  • immediate – occuring within 24h of injury
  • early – occuring within 1-7 days of injury
  • late – more than 7 days post injury

 

Seizure prophylaxis refers to the practice of administering antiseizure medications to patients following head injury to prevent the occurence of seizures

  • It is important to prevent post-traumatic seizures, especially in the immediate and early phase of recovery
  • Seizures may increase intracranial pressure and decrease oxygenation of brain tissues
  • Many antiseizure medications impair cognitive performance prolonging the duration of rehabilitation.
  • Therefore the benefits are weighed against the side effects of antiseizure medication administration
  • Research supports the benefits of immediate and early seizure prophylaxis, yet long term prophylaxis benefits are inconclusive

 

Assessments:

  • careful assessment for seizures must be undertaken

 

Risk factors increasing the likelihood of post traumatic seizures are:

  • brain contusions with subdural hematoma
  • skull fracture
  • loss of consciousness or amnesia of 1 day or more
  • traumatic brain injury patient over 65

 

Other complications of traumatic brain injury include:

Systemic infections

  1. pneumonia
  2. urinary tract infection
  3. septicemia

Neurosurgical infections

  1. wound infections
  2. osteomyelitis
  3. meningitis
  4. ventriculitis
  5. brain abscess
  6. heterotrophic ossification (painful bone overgrowth of weight bearing joints)

Day et al. 2009. Textbook of Medical Surgical Nursing. 1st Can. ed. Lippincott Williams and Wilkins.

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