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Head Injury Information
Information for the Parent of a
Child
With a Mild Head Injury
Your child has a mild head injury. He or she may have experienced
a brief loss of conscious or been "been knocked out". This condition is
called a concussion. Doctors, nurses, and other health care professionals
have and will continue to evaluate her. A child with a mild head injury may
be a little sleepier than usual. She may complain of a headache and
occasionally vomit. She should, however, be speaking clearly, opening her
eyes, and able to move her arms and legs unless she has other injuries that
do not permit movement. Most children with mild head injuries will have
received a CT brain scan. This scan allows evaluation of the brain and the
bones around the brain. Your child's neurosurgeon or trauma surgeon will
discuss the findings of this scan with you. Sometimes the scan needs to be
repeated to check for new areas of injury. However, most of the time the
scan is normal and is not repeated. Your child's doctor can give you more
details.
Children who have mild head injury are often admitted into the hospital for overnight observation. At first, your child will not be allowed to eat or drink until it is clear that he is improving and has sustained no other injuries. After about 8 to 12 hours beverages will be offered and, if he does not vomit, your child will be able to increase his intake back to a normal diet. Children with mild head injuries often have one or two episodes of vomiting and complain of headache but gradually improve over 12 to 24 hours.
Your child will be ready for discharge when she is eating and drinking well and is able to walk without assistance. The activities allowed following discharge will be governed by his level of comfort and other associated injuries. It is important that he avoid other activities that could result in another head injury; such as, football, bike riding, boxing, and similar activities in gym or physical education for at least a month. A second head injury after a first mild head injury may cause serious complications.
Occasionally a child who has experienced a concussion will have continued complaints of headache, difficulty with learning, irritability, or personality changes. These problems usually resolve on their own within a week or two. If the problems persist longer or worsen they should be discussed with your child's neurosurgeon. For further information call Pediatric Neurosurgery at Children's Medical Center of the Medical College of Georgia.
Information for the
Parent of a Child
With of a Child With a Moderate Head Injury
Your child has sustained a moderate head injury. A moderate head
injury includes a period of unconscious (knocked out) followed a period of
lethargy or decreased responsiveness. Your child will tend to want to keep
his eyes closed, may speak only when spoken to, and will be much less active
than usual. Her/His clinical situation will be accessed initially by
doctors, nurses, and other health care professionals and will be reassessed
frequently. Your child will be admitted into the hospital until her/his
condition improves and may be in the intensive care unit or in a hospital
room with monitoring of heart and breathing functions.
Your child will have had a CT scan. His/Her neurosurgeon or trauma surgeon will be able to discuss the CT findings with you. The CT scan shows the anatomy of the brain and bones around the brain and will show if there has been any bleeding in or around the brain, or bone fractures around the brain. If the scan shows abnormalities it will often be repeated within 12 to 24 hours to evaluate these abnormal areas and check if surgery or other interventions are needed.
Children with moderate head injuries often require hospital stays of 2 or 3 days or longer. During that time close monitoring will continue, food and water will be withheld until your child is more alert, IV fluids will continue to allow provision of food, sugar, and salt, and program of rehabilitation with physical and occupational therapy will begin.
A child with a moderate head injury generally makes a slow, but eventually complete, recovery. Your child will be ready for discharge home when he is eating well and is able to walk without assistance. Occasionally a child with moderate head injury will require a period of rehabilitation in a hospital in order to completely recover. Your doctor will discuss the need for such rehabilitation with you.
After discharge it is important that your child avoid any activities which may result in another head injury; such as, boxing, football, and probably avoid bike riding and physical education activities for at least a month. A second head injury may result in serious consequences.
A child with a moderate head injury usually makes a complete recovery. A child with a moderate head injury can complain of headache, can be noted to have personality changes, and may have trouble with school performance. These problems usually resolve in 2 to 4 weeks, but their persistence is a concern. You can discuss these concerns with your child's neurosurgeon. You can get more information about your child's moderate head injury by calling Pediatric Neurosurgery at the Children's Medical Center of Medical College of Georgia.
Information for the
Parent of a Child
With of a Child With a Severe Head Injury
Your child has sustained a severe head injury. She will be
assessed by doctors, nurses, and other health care professionals. A child
with a severe head injury will not open her eyes, follow the doctor's
commands, or speak to doctors and nurses. A child with a severe head injury
is in serious condition and will usually have a tube placed to assist
breathing (an endotracheal tube). A child with a severe head injury will be
cared for in a intensive care unit. Often doctors will place special tubes
and wires through the skull into regions of the brain in order to monitor
the pressure inside the skull. The team responsible for this monitoring is
the pediatric neurosurgery team. In addition, the child with a serious head
injury will be cared for by the pediatric intensive care unit team and the
pediatric trauma team.
Your child will receive a CT scan to evaluate the brain and the bones around the brain. The CT scan will probably be repeated within 12 to 24 hours to be sure that no further damage has occurred. In addition, the CT scan will also be repeated if your child's intracranial pressure rises or if there are other signs detected by doctors or nurses which cause a concern about possible swelling or bleeding in the brain.
The child with a severe traumatic brain injury will often be hospitalized 7 or more days. The initial care will focus on detection of and treatment of brain swelling, a common complication of a traumatic brain injury. Some children will require brain surgery to relieve blood clots around or in the brain. Traumatic brain injuries will also frequently be associated with other injures and your child's care may include many other specialists as dictated by their medical needs.
A severe brain injury can be life threatening. Your child's neurosurgeon, trauma surgeon, and pediatric intensive care physician will share the details of her injury with you and keep you informed as to her progress. Her nurse and respiratory therapist are also there to care for her and support you.
As the child with severe brain injury improves, the medical support will gradually be withdrawn. Medicines used to keep her asleep and not moving will be decreased. Her ability to breath on her own will return and eventually the monitoring tubes and the breathing tube can be removed when she is sufficiently recovered. As she improves she will be well enough to transferred to another floor in this hospital where she can be monitored while in a hospital room. As she improves, rehabilitation therapy including physical and occupational therapy will start.
Many children with severe traumatic brain injuries recover completely or very nearly completely. This process, however, can be prolonged and it is common for children to require a period of rehabilitation either as a inpatient or outpatient. Your child's doctor will discuss this possibility with you as your child begins to recover. The long-term outlook for a child with a severe traumatic brain injury is often difficult to predict initially and will probably require regular consultation between you and your child's neurosurgeon and other physicians. If you have any questions regarding your child's condition contact pediatric neurosurgery at the Children's Medical Center of the Medical College of Georgia.
For more information, contact Pediatric Neurosurgery at (706) 721-5568