What You Need to Know about Brain Injuries in Children
Traumatic brain injury (TBI) is a broad term describing a range of symptoms that can be mild, moderate or severe. TBIs result from a direct or indirect blow to the head. They can include:
- Bumps and bruises
- Concussions
- Skull fractures
- Serious brain injuries
Can a child recover from a traumatic brain injury?
The degree of recovery from a TBI depends on the severity of the injury. Most children recover with no long term problems. However, more severe TBIs can cause lasting damage.
The severity of a TBI is determined by many factors, including:
- Abnormalities detected with head or brain imaging
- Long loss of consciousness
- Memory loss about events immediately following injury
- Neurological symptoms that happened at the time of the injury
- Severity of confusion immediately following the injury
Symptoms can vary depending on the site of injury, extent of damage to the brain and the child’s age or stage of development. Because a child’s brain is still developing, TBI in children is a chronic disease process rather than a one-time event; symptoms may change or become noticeable over time.
What are the types of TBIs?
TBIs are defined as mild, moderate or severe based on the duration of loss of consciousness and memory loss.
| TYPE OF TBI | LOSS OF CONSCIOUSNESS | LOSS OF MEMORY |
|---|---|---|
| MILD (MTBI)* | 30 minutes or less | Not more than 24 hours |
| MODERATE | 1-24 hours | 1-24 hours |
| SEVERE | More than 24 hours | More than 7 days |
*Most concussions are MTBIs
What are the symptoms of TBI?
Regardless of the type of TBI, signs and symptoms may be similar; however, in moderate and severe TBIs, symptoms may be more critical or acute. Symptoms can get worse over time and last weeks, months or longer.
Common signs of a TBI include:
- Physical
- Dizziness
- Blurred or double vision
- Headache(s)
- Increased fatigue (feeling tired)
- Loss of balance and/or trouble walking
- Loss of consciousness
- Nausea or vomiting
- Numbness or tingling
- Ringing in the ears
- Sensitivity to light and/or sound
- Cognitive (brain)
- Confusion/feeling foggy
- Inability to concentrate/decreased concentration
- Falling behind in school
- Memory issues
- Poor judgment
- Slow thinking or slow processing
- Emotional
- Bolder than usual
- Easily frustrated or angered
- Fussiness or irritability
- Impatient
- Lack of interest or motivation in normal things
- More emotional than normal
- Not tolerating or willing to follow daily routine
- Outbursts/tantrums
- Sad or nervous; crying or getting tearful more easily
- Sleeping
- Change in sleeping pattern
- Difficulty staying asleep
- Sleeping more than usual
- Trouble falling asleep
More severe symptoms in a small percentage of children with a TBI include a long loss of consciousness, spasticity, muscle weakness, seizures and more severe brain and functional problems.
How are TBIs in children diagnosed?
If your child has had a head injury or shows signs of a TBI, schedule an appointment with their pediatrician/primary care provider (PCP). The PCP will ask for details of the injury and symptoms and may do a physical and neurological evaluation to assess your child’s:
- Balance
- Coordination
- Muscle strength
- Reflexes
- Sensation
- Vision
- Behavior
- Concentration
- Memory
- Mood
Depending on the results of this evaluation, your child’s medical provider may order an MRI or CT scan and refer your child to a pediatric neurologist.
How are TBIs in children treated?
Your child’s treatment plan will depend on the severity of the TBI as well as your child’s symptoms, age, developmental stage and more. Rest will be recommended to support your child’s brain and body. An individualized treatment plan will be created in partnership with you with the goal of getting your child back to normal activities.
Your child’s treatment plan may include the following medical specialties:
- Behavioral health: Provides treatment of depression, anxiety, disruptive behaviors and tools to support coping skills, pain management and long term emotional recovery from trauma
- Occupational therapy: Helps improve fine motor skills, such as hand-eye coordination; functional skills like getting dressed, grooming, eating and writing; and mental processing and problem solving
- Physical therapy: Increases activity tolerance, balance, flexibility, range of motion, strength, walking and management of musculoskeletal headaches
Speech-language therapy: Improves listening, speaking, reading, writing and social skills - Vision (ophthalmology): Addresses blurry or double vision, eye strain, headaches
- Pain management: Prescription medication(s) or other pain management tools
In extremely rare cases, surgery may also be recommended as part of a child’s treatment plan.
