Risk factors for post-traumatic seizures in patients with penetrating brain injury

Ballistic injuries are a leading cause of penetrating brain injury (PBI) worldwide. PBI is associated with a myriad of complications including seizure. An estimated 26,871 cases of PBI were reported in the United States over five years, and the incidence of post-traumatic seizures estimated at 1 in 50. Despite the presumed high prevalence of seizures in this patient population, there has yet to be investigation into post-traumatic seizures specifically related to PBI. This study aims to investigate the prevalence of seizure in PBI and risk factors associated with post-traumatic epilepsy. This observational study was conducted on data retrospectively collected from patients with gunshot wounds to the head admitted to a single Level 1 trauma center between May 1, 2018 and January 31, 2025 using data from the REDCap PBI database. Patients were stratified by presence of seizure during hospital stay and analyzed for statistical significance of independence using Welch's two sample t-test. Preliminary data analysis show the Glasgow-Coma Scale post 24 hours (CI=0.98), , presence of vascular injury (CI=0.96), injury intention (p=0.02), and bullet traversion across the midline (p=0.02), to be factors associated with post-traumatic seizure in thi patient population.