• TBI
  • Acquired Brain Injury (ABI)

Traumatic Brain Injury

Pediatric traumatic brain injury (TBI) results from a blow to the head or a piercing of the skull by a foreign object. The most common causes of TBI in children and infants are accidental falls and car accidents. Sadly, TBIs can also be a result of Shaken Baby Syndrome (in infants and very young children) or due to an assault by an adult on an older child. TBI causes brain damage and is characterized as mild (and non-lifethreatening) to severe (potentially fatal). Very young children have the highest rate of TBIs, with 1 in 50 children experiencing some form of TBI each year.

Because young children and infants cannot verbally express the experience of a headache, confusion, and/or double vision, parents can look for these signs of a suspected TBI in the youngest of children:

  • Loss of consciousness, even for only a brief period of time
  • Change in nursing or eating habits
  • Crying that does not stop, inability to be consoled
  • Change in irritability
  • Changes in sleep habits
  • Excessive drowsiness
  • Loss of interest in activities
  • Inability to focus

Mild TBI, sometimes called a concussion, while not life-threatening is still a very significant brain injury; it is a medical emergency and must be treated as such. A child with mild TBI will need a great deal of mental and physical rest as the brain heals itself. A child with a concussion who subsequently exhibits further symptoms of moderate to severe TBI (see below) needs immediate medical attention. It is extremely important during concussion recovery that a child not re-injure themselves. Just as a child would not be allowed to participate in sports with a broken arm, so too should a child’s brain be unstressed and given a chance to repair itself for several weeks. Weeks of sleep and rest are needed. 

Signs of concussion may include:

  1. Seizures
  2. Dilation of the pupils
  3. Loss of consciousness or an inability to be woken from sleep
  4. Clear fluid draining from nose or ears

Rehabilitation of moderate to severe TBI in infants and children is now treated as a chronic injury, as children’s brains are still developing and any deficits or disabilities resulting from TBI may emerge years after the injury.

Conventional Treatment

Acute treatment of moderate to severe TBI is aimed at preventing secondary injuries, such as hydrocephalus and infections. Supportive care includes ensuring that oxygen is reaching all parts of the brain and that intracranial pressure is normalized. Surgery may be needed to relieve pressure build up in the brain, remove blot clots, stop bleeding, or repair skull fractures. Patient rest is essential to recovery.

Rehabilitation of moderate to severe TBI in infants and children is now treated as a chronic injury, as children’s brains are still developing and any deficits or disabilities resulting from TBI may not be readily apparent and may emerge years after the injury. Epilepsy is a common development in children who have experienced moderate to severe TBI and may need to be treated with anti-convulsant medications. After experiencing a TBI, children may need to relearn the basic skills of walking, speaking, and eating. They may have continuing problems with memory, learning, problem-solving, and concentration. Traditional rehabilitative treatment addresses cognitive, speech, behavioral, and physical therapies and may be needed for years after the injury has taken place.