A population-based study of seizures after traumatic brain injuries

John F. Annegers, W. Allen Hauser, Sharon P. Coan, Walter A Rocca

Research output: Contribution to journalArticle

644 Citations (Scopus)

Abstract

Background: The risk of seizures is increased after traumatic brain injury, but the extent and duration of the increase in risk are unknown. The purpose of this study was to identify the characteristics of brain injuries that are associated with the development of seizures. Methods: We identified 4541 children and adults with traumatic brain injury (characterized by loss of consciousness, post-traumatic amnesia, or skull fracture) in Olmsted County, Minnesota, during the period from 1935 through 1984. Injuries were classified as mild (loss of consciousness or amnesia lasting less than 30 minutes), moderate (loss of consciousness for 30 minutes to 24 hours or a skull fracture), or severe (loss of consciousness or amnesia for more than 24 hours, subdural hematoma, or brain contusion). We compared the incidence of new unprovoked seizures in this cohort with population rates, using standardized incidence ratios and Cox proportional-hazards analysis. Results The overall standardized incidence ratio was 3.1 (95 percent confidence interval, 2.5 to 3.8). The standardized incidence ratio was 1.5 (95 percent confidence interval, 1.0 to 2.2) after mild injuries but with no increase over the expected number after five years, 2.9 (95 percent confidence interval, 1.9 to 4.1) after moderate injuries, and 17.0 (95 percent confidence interval, 12.3 to 23.6) after severe injuries. In the multivariate analysis, significant risk factors for later seizures were brain contusion with subdural hematoma, skull fracture, loss of consciousness or amnesia for more than one day, and an age of 65 years or older. Conclusions The increased risk of seizures after traumatic brain injury varies greatly according to the severity of the injury and the time since the injury.

Original languageEnglish (US)
Pages (from-to)20-24
Number of pages5
JournalNew England Journal of Medicine
Volume338
Issue number1
DOIs
StatePublished - Jan 1 1998

Fingerprint

Unconsciousness
Seizures
Amnesia
Skull Fractures
Wounds and Injuries
Confidence Intervals
Population
Subdural Hematoma
Incidence
Brain Injuries
Traumatic Brain Injury
Multivariate Analysis

ASJC Scopus subject areas

  • Medicine(all)

Cite this

A population-based study of seizures after traumatic brain injuries. / Annegers, John F.; Hauser, W. Allen; Coan, Sharon P.; Rocca, Walter A.

In: New England Journal of Medicine, Vol. 338, No. 1, 01.01.1998, p. 20-24.

Research output: Contribution to journalArticle

Annegers, John F. ; Hauser, W. Allen ; Coan, Sharon P. ; Rocca, Walter A. / A population-based study of seizures after traumatic brain injuries. In: New England Journal of Medicine. 1998 ; Vol. 338, No. 1. pp. 20-24.
@article{1aae986dc3824dec83fd1c610924069a,
title = "A population-based study of seizures after traumatic brain injuries",
abstract = "Background: The risk of seizures is increased after traumatic brain injury, but the extent and duration of the increase in risk are unknown. The purpose of this study was to identify the characteristics of brain injuries that are associated with the development of seizures. Methods: We identified 4541 children and adults with traumatic brain injury (characterized by loss of consciousness, post-traumatic amnesia, or skull fracture) in Olmsted County, Minnesota, during the period from 1935 through 1984. Injuries were classified as mild (loss of consciousness or amnesia lasting less than 30 minutes), moderate (loss of consciousness for 30 minutes to 24 hours or a skull fracture), or severe (loss of consciousness or amnesia for more than 24 hours, subdural hematoma, or brain contusion). We compared the incidence of new unprovoked seizures in this cohort with population rates, using standardized incidence ratios and Cox proportional-hazards analysis. Results The overall standardized incidence ratio was 3.1 (95 percent confidence interval, 2.5 to 3.8). The standardized incidence ratio was 1.5 (95 percent confidence interval, 1.0 to 2.2) after mild injuries but with no increase over the expected number after five years, 2.9 (95 percent confidence interval, 1.9 to 4.1) after moderate injuries, and 17.0 (95 percent confidence interval, 12.3 to 23.6) after severe injuries. In the multivariate analysis, significant risk factors for later seizures were brain contusion with subdural hematoma, skull fracture, loss of consciousness or amnesia for more than one day, and an age of 65 years or older. Conclusions The increased risk of seizures after traumatic brain injury varies greatly according to the severity of the injury and the time since the injury.",
author = "Annegers, {John F.} and Hauser, {W. Allen} and Coan, {Sharon P.} and Rocca, {Walter A}",
year = "1998",
month = "1",
day = "1",
doi = "10.1056/NEJM199801013380104",
language = "English (US)",
volume = "338",
pages = "20--24",
journal = "New England Journal of Medicine",
issn = "1533-4406",
publisher = "Massachussetts Medical Society",
number = "1",

}

TY - JOUR

T1 - A population-based study of seizures after traumatic brain injuries

AU - Annegers, John F.

AU - Hauser, W. Allen

AU - Coan, Sharon P.

AU - Rocca, Walter A

PY - 1998/1/1

Y1 - 1998/1/1

N2 - Background: The risk of seizures is increased after traumatic brain injury, but the extent and duration of the increase in risk are unknown. The purpose of this study was to identify the characteristics of brain injuries that are associated with the development of seizures. Methods: We identified 4541 children and adults with traumatic brain injury (characterized by loss of consciousness, post-traumatic amnesia, or skull fracture) in Olmsted County, Minnesota, during the period from 1935 through 1984. Injuries were classified as mild (loss of consciousness or amnesia lasting less than 30 minutes), moderate (loss of consciousness for 30 minutes to 24 hours or a skull fracture), or severe (loss of consciousness or amnesia for more than 24 hours, subdural hematoma, or brain contusion). We compared the incidence of new unprovoked seizures in this cohort with population rates, using standardized incidence ratios and Cox proportional-hazards analysis. Results The overall standardized incidence ratio was 3.1 (95 percent confidence interval, 2.5 to 3.8). The standardized incidence ratio was 1.5 (95 percent confidence interval, 1.0 to 2.2) after mild injuries but with no increase over the expected number after five years, 2.9 (95 percent confidence interval, 1.9 to 4.1) after moderate injuries, and 17.0 (95 percent confidence interval, 12.3 to 23.6) after severe injuries. In the multivariate analysis, significant risk factors for later seizures were brain contusion with subdural hematoma, skull fracture, loss of consciousness or amnesia for more than one day, and an age of 65 years or older. Conclusions The increased risk of seizures after traumatic brain injury varies greatly according to the severity of the injury and the time since the injury.

AB - Background: The risk of seizures is increased after traumatic brain injury, but the extent and duration of the increase in risk are unknown. The purpose of this study was to identify the characteristics of brain injuries that are associated with the development of seizures. Methods: We identified 4541 children and adults with traumatic brain injury (characterized by loss of consciousness, post-traumatic amnesia, or skull fracture) in Olmsted County, Minnesota, during the period from 1935 through 1984. Injuries were classified as mild (loss of consciousness or amnesia lasting less than 30 minutes), moderate (loss of consciousness for 30 minutes to 24 hours or a skull fracture), or severe (loss of consciousness or amnesia for more than 24 hours, subdural hematoma, or brain contusion). We compared the incidence of new unprovoked seizures in this cohort with population rates, using standardized incidence ratios and Cox proportional-hazards analysis. Results The overall standardized incidence ratio was 3.1 (95 percent confidence interval, 2.5 to 3.8). The standardized incidence ratio was 1.5 (95 percent confidence interval, 1.0 to 2.2) after mild injuries but with no increase over the expected number after five years, 2.9 (95 percent confidence interval, 1.9 to 4.1) after moderate injuries, and 17.0 (95 percent confidence interval, 12.3 to 23.6) after severe injuries. In the multivariate analysis, significant risk factors for later seizures were brain contusion with subdural hematoma, skull fracture, loss of consciousness or amnesia for more than one day, and an age of 65 years or older. Conclusions The increased risk of seizures after traumatic brain injury varies greatly according to the severity of the injury and the time since the injury.

UR - http://www.scopus.com/inward/record.url?scp=0031975401&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031975401&partnerID=8YFLogxK

U2 - 10.1056/NEJM199801013380104

DO - 10.1056/NEJM199801013380104

M3 - Article

C2 - 9414327

AN - SCOPUS:0031975401

VL - 338

SP - 20

EP - 24

JO - New England Journal of Medicine

JF - New England Journal of Medicine

SN - 1533-4406

IS - 1

ER -