Acute traumatic brain injury and seizures

Head trauma from blunt force or from penetration of the skull causes a sequence of pathophysiologic changes in brain that correlates with the severity of injury. Acute injury precipitates a cascade of changes in brain metabolism, blood flow, and homeostasis that is a threat to survival.

Seizures may occur because of the acute injury and are liable to complicate management. They may be immediate, requiring initiation of treatment at the injury scene, or they may occur later, within the first 24 hours after the injury.1 Phenytoin is an anticonvulsant that is effective in preventing seizures that occur in the acute injury period.2

Of course, the occurrence of a seizure in a patient with a head injury requires immediate brain imaging to define a possible cause, such as the accumulation of blood within the cranium.

Adapted from: Willmore LJ. Head trauma and the development of post-traumatic epilepsy. In: Ettinger AB and Devinsky O, eds. Managing epilepsy and co-existing disorders. Boston: Butterworth-Heinemann; 2002;229–238.
With permission from Elsevier ( 

Authored By: 
LJ Willmore
Steven C. Schachter, MD
Authored Date: 
Reviewed By: 
Steven C. Schachter, MD
Thursday, April 1, 2004