Traumatic Brain Injury In Children

By Lynn L. West, PhDc, BCETS, LCPC

Lynn L. West & Associates, LLC

More Child Health and Safety Articles

Traumatic Brain Injury In Children

Traumatic injuries represent the leading cause of death and disability in young adults in the US. When head trauma is sufficient to cause alterations in consciousness, neurological impairment, or cognitive deficits, an injury to the brain is assumed. Head injuries are broadly classified as being either open or closed depending on whether or not the integrity of the skull has been broken, crushed, torn, or ruptured. The majority of fatalities following head trauma are seen in patients with an open head injury. In closed head injuries, the skull remains relatively intact. Brain damage incurred at the time of impact and brain contusions (bruises) are typically seen at the site of the impact. The force of the impact often causes the brain to rebound inside the skull, hitting the opposite side of the initial blow. The force of impact is the speed of velocity when hit.

Diffuse axonal injury is common following closed head injury and may be responsible for persistent neurologic deficits. Often, axonal injury is not detected in head scans conducted following an injury. Be aware that symptoms related to neurologic deficits can occur any time within a six month to one year “structural” period post impact. Focal neurological deficits involving motor, sensory, or language impairment, attention deficits and distractibility slowed cognitive processing and behavioral responding, impaired learning and retrieval of new information, deficits in auditory and visual processing and organization, impaired motor programming and reaction time are common.

A concussion is an alteration in mental status induced by mechanical forces affecting the brain. This includes transient neurological functioning such as being “stunned”, vacant stare, delayed responding, inability to focus attention, disorientation, confusion, slurred or incoherent speech, motor in-coordination, excessive emotionality, and forgetfulness. Symptoms typically include headache, dizziness, vomiting, nausea, blurred vision, irritability, anxiety, depression, poor memory, impaired concentration, insomnia, and fatigue, visual and auditory complaints.

Structural damage to the brain can be caused by axonal tearing as well as compression or stretching of the axons during the injury. Cells that are not damaged as a result of the impact of head injury never the less are exposed to significant metabolic and neurochemical changes that can affect neurocognitive operations for years after a head injury. Thus, if your child plays sports and/or has ever suffered a brain injury while playing an innocent game where there is physical contact your child could have brain damage that 80% of the time is not identified in MRI. Pay attention to your child’s symptoms.