Case: A baby with post-traumatic seizure

October 1, 2008

A 4-month-old trauma patient is unresponsive after a falling one foot from his bed to the floor.

A new trauma patient has recently arrived from the emergency department (ED) after being transferred from a community hospital. The patient is a previously healthy 4-month-old male who presented to the outside hospital after falling approximately one foot from a platform bed to the floor the night before. He was born full-term and has had normal growth and development to date.

Blood on the brain?

The inciting incident involved the patient falling from a bed onto a thickly carpeted floor. There was no loss of consciousness, and the baby cried immediately. The parents were not concerned until the next day, when they noted that he was not as interactive as usual. He had no emesis however, and continued to take his bottle without difficulty. Later in the day, his mother noted that he didn't seem to be making eye contact with her. She reported that for several seconds that evening, he wouldn't respond when she called his name or touched him, and that his eyes appeared to deviate to the right. At that point, she became extremely alarmed and brought him to the outside hospital.

Per the report from the outside ED, the first episode of unresponsiveness lasted 15 minutes. During that time, IV access was established, labs were sent, and the patient was placed on a stabilizing board with a cervical collar and sent for head CT (computed tomography). The decision was made to transfer the patient to your hospital with the diagnosis of closed head injury with probable post-traumatic seizure.