Neurological monitoring using amplitude-integrated electroencephalogram: two cases of severe traumatic brain injury in children

Abstract

Background: Amplitude-integrated electroencephalogram (aEEG) is now commonly used to monitor cerebral function in neonatal intensive care units (ICU); however, few reports on its use in pediatric and adult ICU's, particularly in patients with traumatic brain injuries, have been written. Case report: The brain function of two patients with severe traumatic brain injuries is monitored using aEEG. In case 1, a three-month-old girl presents with frequent posttraumatic seizures from an acute subdural hemorrhage caused by a motor vehicle accident. aEEG monitoring detects frequent nonconvulsive seizures upon which anti-epileptic drugs are thus administered. In case 2, a seven-year-old boy presents with altered mental status with involuntary movements from diffuse axonal injury also due to a motor vehicle accident. aEEG, however, does not show any evidence of seizure activity. Conclusion: aEEG can be a useful tool to detect posttraumatic seizures and can improve the management of severe traumatic brain injuries in children.