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Invited Critique
September 1, 2005

Head Computed Tomography Scans in Trauma Patients With Seizure Disorder—Invited Critique

Arch Surg. 2005;140(9):864. doi:10.1001/archsurg.140.9.864

It is often difficult to evaluate the postictal patient presenting after a concurrent seizure and traumatic event. Which came first, the chicken or the egg? Did the seizure cause the trauma, or did the trauma cause the seizure? Does the patient have a preexisting seizure disorder, or is this a true posttraumatic seizure due to new brain injury? Neidlinger and colleagues retrospectively examined this important, common clinical scenario in a review of 356 trauma patients presenting with the additional diagnosis of seizure. Their data reinforce previous findings of lower GCS scores and higher likelihood of CT-proven brain injury in patients in whom the seizure resulted from an injury vs those in which the seizure preceded the trauma.

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