Author: Sahar M. Hassanein, MD
Ain Shams University in Cairo, Egypt 

Reviewed: March 2022

SUMMARY

Traumatic brain injury (TBI) is brain damage that comes from an injury to the brain itself. It is a leading cause of death and long-term disability in children.  

TBI can be mild, moderate, or severe. Children with moderate to severe TBI experience problems that persist for life. The problems can affect health, education, psychology, and socialization. Preventing TBI during sports in young children is important.

Disorder Overview

DESCRIPTION

TBI is not a genetic disease. It is something a child acquires before, during, or after birth.  

TBI brain damage results from a bump, blow, or jolt to the head or body. It can also come from an object penetrating the head. Any injury that disrupts normal brain function is considered a traumatic brain injury by the U.S. Centers for Disease Control and Prevention. 

The severity of TBI can be classified as mild, moderate, or severe. Each case can be classified based on: 

• Signs and symptoms  
• Images of the brain 

TBI is a leading cause of death and long-term disability in children. Children with moderate to severe TBI may experience problems that persist for life. Of all child deaths due to injury, about 1 in 3 include TBI as a cause of death.

SIGNS AND SYMPTOMS

TBI can show up with different physical and psychological signs and symptoms. Some manifest immediately after the trauma, while others may appear days or weeks later. Mild TBI can have different symptoms than moderate or severe TBI.

Diagnosis 

Diagnosing TBI and considering its possible outcomes depends on two strategies:

CAUSES

There are many possible causes of TBI.  

Some causes vary by age:

Sports and recreational activities that can cause TBI are known as “preventable TBI causes.” These include: 

• Bicycling 
• Football 
• Basketball 
• Soccer 
• Playground activities 

 Another source of TBI is physical assault.

LABORATORY INVESTIGATIONS

Brain imaging can be used to better understand a case of TBI. Brain imaging can include: 

Blood tests and other investigations might help a medical team understand how to treat other problems resulting from the injury.

TREATMENT AND THERAPIES

Acute Treatment 

A child with TBI will often need immediate treatment. In moderate or severe TBI, the treatment process might look like this:

1. Monitoring begins. The child is continuously checked for level of consciousness, heart rate, respiration, and blood pressure. The pressure inside the brain is also measured. This can help avoid brain damage. 
2. Monitoring continues. Monitoring continues until a child’s level of conscious becomes normalized. 
3. Surgery, if needed. Surgery might be needed to remove blood in the brain from internal bleeding. Surgery is also sometimes used to help take pressure off the brain to avoid further brain damage.  

Many scales can be used to assess a child’s level of consciousness. One commonly used scale is the Pediatric Glasgow Coma Scale. 

Rehabilitation 

Rehabilitation begins after acute treatment. This can include: 

OUTCOMES

The long-term outcomes of TBI can vary depending on:

• The location of the injury in the brain 
• The severity of the injury 
• The age of child 

Depending on the severity of the brain damage, a child may need: 

•  Neuropsychological testing 
• School accommodations 

Potential complications include:

• Seizures 
• Headaches 
• Infection 
• Stroke 

Cases of mild TBI often have no long-term effects. 

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Research 

ClinicalTrials.gov for Traumatic Brain Injury (birth to 17 years).

These are clinical trials that are recruiting or will be recruiting. Updates are made daily, so you are encouraged to check back frequently.   

 ClinicalTrials.gov is a database of privately and publicly funded clinical studies conducted around the world. This is a resource provided by the U.S. National Library of Medicine (NLM), which is an institute within the National Institutes of Health (NIH). Listing a study does not mean it has been evaluated by the U.S. Federal Government. Please read the NLM disclaimer for details.    

Before participating in a study, you are encouraged to talk to your health care provider and learn about the risks and potential benefits. 

The information in the CNF Child Neurology Disorder Directory is not intended to provide diagnosis, treatment, or medical advice and should not be considered a substitute for advice from a healthcare professional. Content provided is for informational purposes only.  CNF is not responsible for actions taken based on the information included on this webpage. Please consult with a physician or other healthcare professional regarding any medical or health related diagnosis or treatment options. 

Flanagan SR. Invited commentary on “Centers for Disease Control and Prevention report to Congress: Traumatic brain injury in the United States: Epidemiology and rehabilitation”. Arch Phys Med Rehabil. 2015 Oct;96(10):1753-5. https://doi.org/10.1016/j.apmr.2015.07.001. Epub 2015 Jul 14. PMID: 26184889.  

Finch J, Ford C, Lombardo C, Meiser-Stedman R. A survey of evidence-based practice, training, supervision and clinician confidence relating to post-traumatic stress disorder (PTSD) therapies in UK child and adolescent mental health professionals. Eur J Psychotraumatol. 2020 Sep 17;11(1):1815281. https://doi.org/10.1080/20008198.2020.1815281. PMID: 33062214; PMCID: PMC7534373.  

Posttraumatic stress disorder (PTSD) in children [Internet]. Stanford Children’s Health. [cited 2022 Feb 3]. Available from: https://www.stanfordchildrens.org/en/topic/default?id=post-traumatic-stress-disorder-in-children-90-P02579/  

Traumatic Brain Injury Resource Guide [Internet] Children safety network 2020. https://www.childrenssafetynetwork.org/resources/traumatic-brain-injury-resource-guide 

https://www.mayoclinic.org/diseases-conditions/traumatic-brain-injury/symptoms-causes/syc-20378557