Traumatic Brain Injury



Traumatic brain injury (TBI) is a medical-surgical emergency and a frequent reason for referral to emergency rooms and for hospitalization, particularly among young and elderly patients. It is a clinically heterogeneous condition, comprising mild to severe forms. Before the advent of imaging, electroencephalogram (EEG) was used in the first assessment of patients with acute TBI. Today, computed tomography and other neuroimaging techniques have substituted EEG as first-line investigations for the diagnosis of cerebral lesions following head trauma. However, EEG continues to have a relevant role in monitoring brain functional activity in patients with TBI and in detecting post-traumatic epileptogenic foci.


Breach effect Post-traumatic epilepsy Subdural hematoma Traumatic brain injury 


  1. 1.
    Hawryluk GW, Manley GT. Classification of traumatic brain injury: past, present, and future. Handb Clin Neurol. 2015;127:15–21.CrossRefGoogle Scholar
  2. 2.
    Galovic M, Schmitz B, Tettenborn B. EEG in inflammatory disorders, cerebrovascular diseases, trauma, and migraine. In: Schomer DL, Lopes da Silva F, editors. Niedermeyer’s electroencephalography: basic principles, clinical applications, and related fields. 7th ed. Oxford: Oxford University Press; 2018. p. 371–412.Google Scholar
  3. 3.
    Nuwer MR, Hovda DA, Schrader LM, Vespa PM. Routine and quantitative EEG in mild traumatic brain injury. Clin Neurophysiol. 2005;116:2001–25.CrossRefGoogle Scholar
  4. 4.
    Ronne-Engstrom E, Winkler T. Continuous EEG monitoring in patients with traumatic brain injury reveals a high incidence of epileptiform activity. Acta Neurol Scand. 2006;114:47–53.CrossRefGoogle Scholar
  5. 5.
    Williams CS, Spitz MC, Foley JF, Weaver LK, Lindblad AS, Wierzbicki MR. Baseline EEG abnormalities in mild traumatic brain injury from the BIMA study. Undersea Hyperb Med. 2016;43:521–30.PubMedGoogle Scholar
  6. 6.
    Brigo F, Cicero R, Fiaschi A, Bongiovanni LG. The breach rhythm. Clin Neurophysiol. 2011;122:2116–20.CrossRefGoogle Scholar
  7. 7.
    Fisher RS, Acevedo C, Arzimanoglou A, Bogacz A, Cross JH, Elger CE, Engel J Jr, Forsgren L, French JA, Glynn M, Hesdorffer DC, Lee BI, Mathern GW, Moshé SL, Perucca E, Scheffer IE, Tomson T, Watanabe M, Wiebe S. ILAE official report: a practical clinical definition of epilepsy. Epilepsia. 2014;55:475–82.CrossRefGoogle Scholar
  8. 8.
    Beghi E, Carpio A, Forsgren L, Hesdorffer DC, Malmgren K, Sander JW, Tomson T, Hauser WA. Recommendation for a definition of acute symptomatic seizure. Epilepsia. 2010;51:671–5.CrossRefGoogle Scholar
  9. 9.
    Hesdorffer DC, Benn EK, Cascino GD, Hauser WA. Is a first acute symptomatic seizure epilepsy? Mortality and risk for recurrent seizure. Epilepsia. 2009;50:1102–8.CrossRefGoogle Scholar
  10. 10.
    Annegers JF, Hauser WA, Coan SP, et al. A population-based study of seizures after traumatic brain injuries. N Engl J Med. 1998;30:20–4.CrossRefGoogle Scholar
  11. 11.
    Frey LC. Epidemiology of posttraumatic epilepsy: a critical review. Epilepsia. 2003;44(Suppl 10):11–7.CrossRefGoogle Scholar
  12. 12.
    Temkin NR. Preventing and treating posttraumatic seizures: the human experience. Epilepsia. 2009;50(Suppl 2):10–3.CrossRefGoogle Scholar
  13. 13.
    Thompson K, Pohlmann-Eden B, Campbell LA, Abel H. Pharmacological treatments for preventing epilepsy following traumatic head injury. Cochrane Database Syst Rev. 2015;8:CD009900.Google Scholar
  14. 14.
    D’Ambrosio R, Perucca E. Epilepsy after head injury. Curr Opin Neurol. 2004;17:731–5.CrossRefGoogle Scholar
  15. 15.
    Young GB, Wang JT, Connolly JF. Prognostic determination in anoxic-ischemic and traumatic encephalopathies. J Clin Neurophysiol. 2004;21:379–90.PubMedGoogle Scholar
  16. 16.
    De Reuck J. Risk factors for late-onset seizures related to cerebral contusions in adults with a moderate traumatic brain injury. Clin Neurol Neurosurg. 2011;113:469–71.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Neurosciences, Biomedicine and Movement SciencesUniversity of VeronaVeronaItaly
  2. 2.Department of NeurologyHospital Franz TappeinerMeranoItaly
  3. 3.Department of Human NeurosciencesSapienza University of RomeRomeItaly

Personalised recommendations