Treating Traumatic Brain Injuries in Children and Adolescent Patients
According to the U.S. Centers for Disease Control and Prevention (CDC), more than 475,000 young people suffer traumatic brain injuries every year. Traumatic brain injuries (TBI) cause neurological deficits in children and adolescents and can disrupt the mind’s normal cognitive functions. Catastrophic head trauma causes these acquired, non-degenerative brain injuries.
These devastating injuries can have long-term impacts on affected people, and may cause cognitive impairment, permanent disabilities, and even death.
CDC scientists recently released a study about the challenges young TBI patients and their families face. The agency submitted its 2018 Report Congress on the Management of Traumatic Brain Injury (TBI) in February. Researchers found troubling healthcare gaps that may impede young TBI patients’ recovery. The investigators also discovered that many children endured lifelong problems when they didn’t receive the right treatment at the time of their injury.
Childhood TBI patients deserve quality treatment that will give them the best chance at recovery. Did your child suffer a traumatic brain injury due to another person’s negligence? Contact the Dolman Law Group in Tampa Bay, Florida. Our experienced TBI attorneys can help you seek compensation for your injuries. Call us today at (727) 451-6900, or contact us online, to schedule a free consultation.
Young TBI patients face different health challenges than their adult counterparts. Children have young, developing brains, which heightens their risk for ongoing cognitive issues following an injury. Doctors call this a chronic disease process.
No two kids will experience the same health issues or impacts following a TBI. Some parents won’t learn how the TBI affected their children’s cognitive abilities until much later in life.
Long term issues related to TBI include:
- Behavioral issues
- Anxiety, depression, and mental health issues
- Learning disabilities and academic issues
- Problems finding or keeping jobs
- Social isolation
- Limited participation in activities
- Incarceration and criminal behavior
- An increased risk for multiple sclerosis, dementia, and Parkinson’s disease in later life.
- Socialization problems
- Motor-related issues
A National Institutes of Health study discovered that children with moderate or severe TBI may have unfavorable outcomes six months after their injury. Physicians should monitor your child’s medical status after a TBI, as they can suggest beneficial therapies and treatments to improve his or her prognosis.
Childhood TBI Injuries: Myths and Misconceptions
Oftentimes, medical professionals provide incorrect information regarding traumatic brain injuries to parents, educators, and rehabilitation specialists. These are five common myths that may impair a child’s treatment progress:
- Myth #1: Mild traumatic brain injuries (mTBI) are less damaging than more severe ones.
- Fact: While more than 90 percent of mTBI patients recover, not all do. Some children with mTBI may experience chronic issues that require ongoing therapy, whereas some children who suffer a severe injury may completely recover.
- Myth #2: Younger patients heal better because their brains aren’t yet fully developed.
- Fact: Brains that are still developing are more vulnerable to long-term issues. Undeveloped brain sections may grow from previously damaged brain tissue, and these problematic areas can cause your child to develop serious cognitive issues.
- Myth #3: Recovering from a TBI only takes one year.
- Fact: The concept of recovery implies that a child has temporarily lost their cognitive abilities, and also suggests that he or she will regain these functions in the future. Unfortunately, this is not always the case. Many childhood TBI victims may appear to fully recover on the surface, but they may still experience long-term adjustment issues.
- Myth #4: Children recover faster from a brain injury if they work hard.
- Fact: No two children’s brains are the same, and the recovery process varies between children. Hard work does not guarantee a child will recover. Rather, the prognosis depends on the severity and location of the injury.
- Myth #5: Young people with moderate or severe TBI stay in the hospital for a longer time than those who suffer mTBI.
- Fact: Younger patients with serious brain injuries don’t have the same health care options that adults do, and their rehabilitation choices may be limited. For example, most children receive treatment for their brain injuries at their local school, rather than at a research hospital.
Initial Test: the Glasgow Coma Scale Assessment
Doctors generally follow a standard health protocol when treating children with suspected brain injuries. When your child sustains a head injury, healthcare workers conduct a thorough exam to gauge his or her consciousness levels.
First, medical workers will use the Glasgow Coma Scale (GCS) to assess your child’s cognitive issues. Researchers Graham Teasdale and Bryan Jennett developed the scale in 1974, and it measures brain impairment and responsiveness in acute brain injury patients. The GCS gathers this information from children’s visual, verbal, and motor responses.
The GCS helps doctors determine whether an injured child has a mild, moderate, or severe TBI, and it also allows physicians to predict any future complications associated with the injury. Each cognitive ability earns a score from three to 15 on the GCS. Moderate and severe TBI injuries receive low scores; mild injuries receive higher scores.
Investigating the Incident that Caused Your Child’s TBI
Next, hospital staff will investigate the circumstances surrounding your child’s brain injury. This information helps physicians determine whether the trauma arose from accidental or intentional acts, and it provides critical information about the object that injured your child and the force of the blow.
The physicians may ask how your child reacted following the accident. For example, did your child remain conscious, or did they pass out immediately? These details will help the physician assess the severity of your child’s TBI.
Doctors will also ask the following questions about your child’s injury:
- How did your child get injured?
- Where did the object strike your child’s head?
- Did your child lose consciousness after the incident?
- How long did your child remain unconscious?
- Did your child experience changes in their speaking, coordination, or alertness?
- What was the force of the injury? (Did they fall, and if so, how far? Did an object like a ball hit your child?)
- Was your child’s body shaken or jolted during the incident?
Screening Tests for Traumatic Brain Injuries
Your physician will order imaging tests to assess TBI patients before performing any surgery. Neurologists primarily rely on two tests to identify brain damage in children:
- Computerized tomography (CT) scan – ER doctors order this test to diagnose suspected TBI. This screening uses X-rays to view the brain, and can identify fractures, blood clots (hematomas), bruised tissue (contusions), tissue swelling, and brain bleeding (hemorrhage).
- Magnetic resonance imaging (MRI) scan – The radio waves emitted by an MRI create a comprehensive brain image. Neurologists use these screenings to monitor stabilized patients. The tests help physicians find problematic areas if children don’t improve after surgery.
Intracranial pressure monitors are another important part of a TBI patient’s recovery, particularly if they experienced tissue swelling, which heightens a child’s risk for brain damage. Physicians use an intracranial monitor to evaluate swelling and determine appropriate treatment.
Mild Traumatic Brain Injury Treatments
Most mild traumatic brain injuries need no treatment other than pain relievers for headaches. However, you should monitor your child at home to watch for chronic or persistent symptoms.
According to Dr. Robert Cantu—the Chief Neurosurgeon at Emerson Hospital in Massachusetts—there are four “baskets“ of concussion symptoms in children, which include:
- Emotion – Young TBI patients may experience problems with anxiety, depression, and anger.
- Cognition – Injured children may have problems with memory, schoolwork, and focus.
- Sleep – TBI patients often sleep more following their injuries. After they heal, they may suffer from insomnia.
- Physical – Somatic symptoms include headaches, lightheadedness, and dizziness.
Following their child’s head injury, parents should limit activities that require thinking, which may make your child’s injury worse. Your doctor will tell you when it’s all right for your child to resume academic and extracurricular activities.
Moderate and Severe TBI Treatments
Moderate and severe TBI patients may require emergency treatments to limit trauma caused by their head injury. Injured individuals will receive oxygen to keep their brain cells alive. Physicians may operate to ensure that the brain tissue has an adequate blood supply. During surgery, doctors may remove blood clots and repair fractures. Additionally, medical personnel will try to minimize secondary damage from inflammation, bleeding, and reduced oxygen to the brain.
Medications to Treat Young TBI Patients
Swelling is a problem some young patients experience following a TBI, and it can potentially cause even more serious damage than the primary injury. Doctors may give children the following medications to treat these problems:
- Anti-seizure medications – Seizures can cause hippocampal damage, and these drugs help prevent that.
- Coma-inducing medication – During a coma, the brain uses less oxygen. Physicians can place TBI patients into an induced coma to prevent more damage to their brain, which may reduce swelling.
- Diuretics – These drugs decrease any brain tissue fluid that may cause swelling.
Surgical Procedures for Childhood TBI
Surgery is another treatment that neurologists recommend to treat moderate to severe TBI. Young TBI patients may need life-saving emergency surgery to repair brain damage. Neurosurgeons frequently perform the following procedures to prevent permanent disabilities:
- Opening the skull – This procedure relieves brain pressure and drains cerebrospinal fluid.
- Hematoma removal – Another danger TBI patients face is hematomas. Doctors may perform surgery to remove clots outside the brain.
- Eliminating bleeding – Neurologists will repair damaged vessels inside the brain to reduce bleeding.
- Repairing fractures – Doctors may perform surgery to repair skull fractures. Bone fragments can damage the brain and cause permanent injuries.
Patient Education Following Release
Children who survive a TBI need long-term care and rehabilitation to fully recover. Parents should receive discharge instructions from the hospital, and they should follow these procedures to avoid TBI-related complications that their children may face following surgery.
Physicians will monitor a child’s symptoms based on his or her medical history. They will conduct assessments to determine if a child will have ongoing symptoms. Nurses may also provide referrals to rehabilitation services.
Discharge instructions should include the following information:
- Information on how to identify worsening TBI symptoms
- Information about the severity of your child’s TBI
- A recovery timeline
- Information for caretakers about how to identify any post-brain injury or concussion symptoms
- Instructions about how to prevent relapses
Rehabilitation to Help Your Child Heal
Many young TBI patients need rehabilitation. Occupational therapists help children relearn important cognitive, communication, and motor skills. Medical specialists will review your child’s medical needs and neurological status, and they will measure any progress your child makes in speech, hearing, and mental areas.
The following specialists may help treat your child:
- Psychiatrists – These professionals oversee a child’s psychological progress after a TBI. They monitor kids’ abilities to adapt to school and work following their injuries. Psychiatrists also may prescribe medicines to treat mental illness.
- Occupational therapists – The specialists help children recover, often by using fun activities. These events help young people relearn basic skills, like walking.
- Speech therapists – Language pathologists help children improve their communication skills following an accident.
- Social workers – These administrators help parents with care-related decisions, often acting as a liaison with doctors, nurses, and school officials. Social workers can also develop special educational plans with modified classes and physical accommodations for disabled students.
- Rehabilitation therapists – These specialists will provide a rehabilitation regimen and often coordinate TBI patients’ home care after they’re discharged from the hospital.
- TBI nursing specialists – These workers provide therapeutic care for TBI patients and educate parents about their children’s recovery prognosis.
- Recreational therapists – These professionals often schedule engaging, fun activities to help children recover.
- Vocational counselors – These counselors tell parents when their children should start school again, and also provide academic and employment resources to help injured children succeed.
- Special education services – Children’s schools may offer speech-language therapy, special education courses, and individualized educational plans.
Returning to School After a TBI
A TBI can forever change a child’s mental abilities. Young TBI victims may appear to function normally, but they may actually have serious cognitive challenges.
Parents should carefully plan their child’s return to school following a TBI. Young TBI patients may have different academic and psychological needs following their injuries than they did before. According to the Brain Injury Foundation of America, children often remember where they were before an accident, and they may suffer from post-traumatic stress afterward.
Caretakers should manage the expectations for recovery of children’s relatives, teachers, and peers. Young TBI victims may have difficulty adjusting to school after their accident, and all children will react differently. Many suffer from memory and comprehension issues, and they may not be able to finish schoolwork in a timely manner.
Parents of TBI victims should meet with their school district’s administrators to discuss their child’s injuries. Parents should ask administrators to provide special accommodations for your child following an accident. Next, parents should have their child’s cognitive and academic abilities assessed by a neuropsychologist; a good school psychologist can also perform these assessments. Afterward, parents should provide their child’s school with the required disability documentation to receive special accommodations.
Hire Experienced Tampa Bay Attorneys for Your Child’s TBI Case
Children who suffer TBI can experience long-term issues and permanent disabilities. Has your child a suffered a TBI due to someone else’s careless actions? If so, you need an experienced legal team that can help you seek compensation. Call the Dolman Law Group, located in Tampa Bay, today at (727) 451-6900 or contact us online, to schedule a free consultation with one of our experienced TBI attorneys.
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