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Chapter 61 - Non-accidental brain injury

from Section 3 - Symptomatic epilepsy

Published online by Cambridge University Press:  05 March 2012

Simon D. Shorvon
Affiliation:
National Hospital for Neurology and Neurosurgery, London
Frederick Andermann
Affiliation:
Montreal Neurological Hospital and Institute
Renzo Guerrini
Affiliation:
Child Neurology Unit, Meyer Pediatric Hospital, Florence
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Summary

Head injuries may result from impact or shaking or a combination of these mechanisms, which act through translational or rotational forces. The classic presentation of non-accidental brain injury (NABI) in infants is the shaken baby syndrome (SBS), which is characterized by widespread parenchymal damage, diffuse axonal injury, subdural and/or subarachnoid hemorrhages, and retinal hemorrhages. Seizures occur more frequently in children with inflicted versus non-inflicted traumatic brain injury. Radiological imaging plays a crucial role in investigating NABI, in order to assess intracranial complications, guide clinical management, and provide documentary evidence for forensic investigation. Magnetic resonance imaging (MRI) detects hemorrhage in the sub acute stage (3-14 days) and demonstrates with high sensitivity early ischemic changes and diffuse axonal injury. Phenytoin has been considered the drug of choice for preventive treatment of early and late seizures while carbamazepine and valproate would be more suitable for the treatment of late seizures.
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The Causes of Epilepsy
Common and Uncommon Causes in Adults and Children
, pp. 425 - 432
Publisher: Cambridge University Press
Print publication year: 2011

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