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Traumatic head injury mimicking acute encephalopathy with biphasic seizures and late reduced diffusion
Author(s) -
Inoue Hirofumi,
Hasegawa Shunji,
Kajimoto Madoka,
Matsushige Takeshi,
Ichiyama Takashi
Publication year - 2014
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.12411
Subject(s) - medicine , status epilepticus , epilepsy , head injury , anesthesia , encephalopathy , white matter , head trauma , magnetic resonance imaging , surgery , radiology , psychiatry
Abstract Many studies have reported acute encephalopathy with biphasic seizures and late reduced diffusion ( AESD ) associated with viral infection at onset, but few studies have reported AESD without infection. We report the case of a 9‐month‐old boy who had a clinical course mimicking AESD after a traffic accident. The traffic accident caused a mild subdural hematoma without neurological abnormalities on admission. The boy became unconscious on the second day, and he was diagnosed with non‐convulsive status epilepticus on the third day. Diffusion‐weighted imaging showed reduced water diffusion in the subcortical white matter. On laboratory analysis interleukin ( IL )‐6 was elevated in the cerebrospinal fluid ( CSF ), but not in the serum. He had severe neurological sequelae with mental retardation, spastic tetraplegia, and epilepsy. We suggest that brain damage mimicking AESD was caused by the traffic accident and the prolonged seizure during infancy.