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Traumatic Brain Injury

Introduction

Here you’ll find answers to some of the questions that parents often have about this condition. Additional resources are listed at the bottom of the page. Diagnosis and management information can be found in the Traumatic Brain Injury module, which is written for primary care clinicians but also may be of help to parents and family members.

What is traumatic brain injury and what causes it?

Traumatic brain injury (TBI) is caused by a sudden trauma to the head resulting in damage to the brain and is sometimes referred to as a head injury or acquired brain injury. TBI is not hereditary, congenital, degenerative, or related to birth trauma. The individual may or may not have experienced a loss of consciousness at the time of the trauma. TBIs are categorized as mild, moderate, or severe.

What are the symptoms of traumatic brain injury?

Symptoms can range from relatively mild (dizziness, fatigue, headaches) to extremely serious (seizures, slurred speech, confusion, loss of coordination, vegetative state).

How is it diagnosed?

After a head trauma, providers assess children for signs and symptoms of traumatic brain injury. Sometimes a TBI is very obvious whereas other times it may be subtle, such as a mild concussion. Brain imaging either by CT scan or MRI may be performed to allow further assessment of damage to the brain.

What is the prognosis?

Prognosis depends on the extent of the TBI. Children with a mild concussion usually heal completely whereas those with more severe traumatic brain injury may have lifelong problems such as difficulty walking and thinking.

What is the risk for other family members or future babies?

There is no genetic risk to TBI and, therefore, no risk to other family members or future babies.

What treatments/therapies/medications are recommended or available?

Treatment will depend on the severity of injury but there are many treatment options. If your child has a severe TBI he or she will receive rehabilitation therapy to make sure your child is functioning in the best possible manner. Depending on the injury, these treatments may involve speech, physical, or occupational therapy, educational help, injections to help manage spasticity that sometimes develop after brain injury, and other treatments.

How will my child and our family be impacted?

The degree to which you and your child will be impacted will depend on the extent of the TBI. Children who have a mild concussion will usually be back to normal quite quickly whereas those with severe TBIs may need lifelong help with activities of daily living.

Our child's doctors told us that it would be years before we would know how our toddler would recover from his fall. Why can't they tell us now?

There are many reasons why it is difficult to predict the outcome of brain injury in children. It is more difficult to determine pre- and post-injury function in a toddler than in an adult where work and academic records are available. It used to be thought that children were more resistant to residual effects of a brain injury because their brains could "rewire" connections lost during the brain injury. However, we now know that children may be more susceptible to injury, although the damage may not be evident for years. For instance, injury to the brain's reading and writing areas won't be obvious until the child reaches school age and is expected to learn these skills. "Frontal lobe functions" develop in adolescence and adulthood. These functions include high-level reasoning and control of social interactions and interpersonal skills, particularly inhibiting behaviors that aren't acceptable in society. If a child's frontal lobe is injured, it may not be apparent until the related skills are expected to be present.
Periodic re-evaluation will be necessary during the school years. Acting early, if problems are observed, is key to minimizing complications and maximizing your child's functioning. Different services are available for children depending upon the child's age. See Early Services, 0-5 Years, From Preschool to Kindergarten/Elementary School, and Special Education.

Resources

Information & Support

Where can I go for further information?

For Parents and Patients

Support

Brain Injury Association of America
Links to resources, publications, and information about policy/legislation and state chapters.

Brain Injury Alliance of Utah
Education and support for the prevention and recovery of brain injury. Lists services (support groups, helpline, community education, conferences, legislative liaisons) and offers family education (simple definitions, a map of the brain with explanations of function, consequences of injury and more).

Q&As about Pediatric TBIs (NRC)
Answers for patients, parents, and families to questions about basic problems and special issues after brain injury; National Resource Center for Traumatic Brain Injury.

General

TBI Resource Guide (CSN)
Comprehensive list of national , informational, educational, and organizational resources related to traumatic brain injury; Children's Safety Network.

TBI Resources for Educators (USOE)
Presentations, reports, and guides to provide strategies in working with students with traumatic brain injury; Utah State Office of Education.

Traumatic Brain Injury (CDC)
Educational initiatives and campaigns for clinicians, parents, educators, coaches, and individuals including children with TBI. Free, downloadable materials and fact sheets; Centers for Disease Control and Prevention.

Traumatic Brain Injury (NINDS)
Overview and links to publications and relevant organizations - not pediatric-specific; National Institute of Neurological Disorders and Stroke.

Traumatic Brain Injury (NICHCY)
Parent-focused page about TBI, includes information about education; National Dissemination Center for Children with Disabilities.

National Resource Center for Traumatic Brain Injury
Practical information for professionals, persons with brain injury, and family members.

Family Functioning Following Pediatric Traumatic Brain Injury (Word Document 80 KB)
Information about family adaption after TBI and characteristics of healthy families, re-entry into community and school, role of the pediatrician, and family functioning research; Brain Injury Association of Washington.

Pediatric Neuropsychology: A Guide for Parents (PDF Document 456 KB)
Describes pediatric neuropsychology, how it differs from a school psychological assessment, reasons for referral, what is assessed, what it will tell you about your child, and how to prepare for the test.

Types of Memory (PDF Document 59 KB)
A five-page handout developed by Dr. Glen Johnson, Clinical Neuropsychologist, that describes the types of memory, things that affect memory, and tips for improving memory.

Fatigue (PDF Document 41 KB)
Courtesy of Dr. Glen Johnson, Clinical Neuropsychologist, this handout describes fatigue and ways to adjust to the fatigue factor.

Traumatic Brain Injury (MedlinePlus)
Offers an overview and an extensive compilation of links to reliable web sites and organizations related to TBI; National Library of Medicine and National Institutes of Health.

Brainline Kids – Helping Kids with Brain Injury
BrainLine Kids, a feature of Brainline.org, provides information about children ages birth through 22 years who are affected by Traumatic Brain Injury.

Abusive Head Trauma / Shaken Baby Syndrome (Nemours)
Signs, symptoms, outcomes, and prevention of abusive head trauma/shaken baby syndrome; KidsHealth.

Easter Seals
Nonprofit organization offering services for individuals with disabilities and their families. Primary services include medical rehabilitation, early intervention, physical and occupational therapy, speech and hearing therapy, child care, recreation, and transition.

When your Child is in the Hospital
Information about TBI specific to the Boston area. Good tools/resources for families in any state; Children’s Hospital, Boston.

Pressure Ulcer Resource Guide (PressureUlcer.net)
Information for families and caregivers about pressure ulcer types, causes, treatments, preventions, and remedies.

Brain Injury: The ABC Years (PDF Document 90 KB)
According to the Centers for Disease Control and Prevention (CDC), an estimated 5.3 million Americans currently live with disabilities resulting from brain injuries. A publication of the Brain Injury Association of America.

Infant Head Injury
Any kind of head injury can be scary, but when the injured is a young child or baby, it becomes even harder to assess the damage.

Traumatic Brain Injury, Susan's Story (NICHCY)
Explanation of traumatic brain injury, tips for parents and teachers, and a listing of resources and organizations; National Dissemination Center for Children with Disabilities.

The Road to Rehabilitation Series (BIAUSA) (PDF Document 758 KB)
Eight articles (total 80 pages) for TBI patients and families about dealing with pain, headaches, cognition and memory, behavior changes, speech and language, drug therapy, spasticity, and concussion/mild brain injury; Brain Injury Association of America.

Services

Adaptive Recreation

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Assistive Technology

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Audiology

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Brain Injury Clinics

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College Disability Centers

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Crisis Intervention Mental Health

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Disability Employment

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Disability Transportation

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Disability/Diagnosis-Specific Advocacy

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Early Intervention Programs

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Educational Advocacy

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Family Support Organizations

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Financial Assistance, Other

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Financial Counseling

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Independent Living

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Local Support Groups, Disability/Diag

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Medicaid

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Mental Health Counselors (LPC, CMHC)

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Neuropsychology

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Occupational Therapy, Pediatric

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Pediatric Gastroenterology

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Pediatric Neurology

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Pediatric Neurosurgery

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Pediatric Ophthalmology

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Pediatric Orthopedics

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Pediatric Otolaryngology

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Pediatric Physical Medicine & Rehab

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Pediatric Sleep Medicine

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Physical Therapy

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Psychiatrist, Child-18

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Psychologist, Child-18

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Residential Services, Disability

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Services for People with Disabilities

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Speech/Language Therapy

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State Disability Agencies

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State Financial Agencies

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For other services related to this condition, browse our Services categories or search our database.

Studies

Brain Injuries in Children (clinicaltrials.gov)
Listing of clinical trials related to brain injuries in children.

Authors

Compiled and edited by: Lynne M Kerr, MD, PhD - 10/2012
URLEND Trainees, 2011-2012 - 10/2012
Content Last Updated: 1/2016

Funding/Support

The Medical Home Portal thanks the 2011-2012 URLEND Medical Home Portal trainees group for their contribution to this page.