Pediatric Traumatic Brain Injuries: Frequency, Causes, and Side Effects

Traumatic brain injuries, also known as TBI, are a leading cause of death and disability among children. Side effects of TBI can include lifelong cognitive challenges in school, relationships, and social settings. Understanding the leading causes and treatment of TBI is important for preventing accidents and knowing how to respond if they happen.

What is a traumatic brain injury?

TBI is a form of brain injury caused by a sudden impact on the brain that results in permanent, lasting damage. Damage caused by TBI can either be localized or spread throughout the brain. In children, TBI is considered a chronic condition. As the child’s brain is still developing, both the side effects and the injury’s extent will manifest over time.

How common are pediatric traumatic brain injuries?

Traumatic brain injuries are more prevalent than any other disease and occur across all races and genders. According to the CDC, the leading cause of death and disability in children ages 0-4 and 15-19 is a traumatic brain injury. Studies show an estimated incidence of pediatric TBI of 691 per 100,000 children.

Types of TBI

TBI can be classified into three types: mild, moderate, and severe. The type of TBI a patient is diagnosed with is based on three factors:

  • How long (and if) the child experienced a loss of consciousness
  • Whether the child experienced post-traumatic amnesia and for how long
  • How confused the child was following the injury

TBI can be caused by either a primary or secondary injury. Primary injuries occur at the time of impact and include fractures, blows to the head, concussions, and brain bleeds. Secondary injuries, however, occur as complications of the initial insult. Secondary injury includes lack of sufficient oxygen or blood flow, brain swelling, and blood pressure change leading to brain damage. 

What causes traumatic brain injuries in children?

There are various causes of TBI, the frequency of which vary by age.

  • Falling: According to the CDC, falling accounts for 50.2% of TBI in children between 0 and 14. Falls among children often occur on stairs, off a bed, or in the bath.
  • Near-drowning: Children can also experience TBI from near-drowning. An estimated 5,000 children are hospitalized yearly from near-drowning, with 15% experiencing severe, lifelong loss of brain function, damaging their ability to think and remember.
  • Choking: Choking is another cause of pediatric TBI. For children aged three and under, choking is a leading cause of death and injury and can lead to brain damage. A child whose brain is deprived of oxygen for longer than 4-6 minutes can sustain lifelong cognitive disabilities.

Side effects of TBI

Children diagnosed with TBI may experience a range of outcomes and symptoms. Here are a few of the most common side effects:

  • Decreased awareness or responsiveness: Children with severe TBI may enter a coma or vegetative state, have decreased self-awareness, or experience brain death (an irreversible condition characterized by no detectable brain activity).
  • Headaches: Chronic headaches lasting several months are common among patients with pediatric TBI.
  • Infections: If the tissue around the brain has been damaged, patients may experience infections such as meningitis.
  • Fluid buildup: Fluid buildup can cause swelling and pressure in the brain.
  • Nerve damage: Nerve damage can result in facial paralysis, hearing loss, vision problems, and dizziness.

Treatment of Pediatric TBI

Unfortunately, the initial trauma a patient experiences from a traumatic brain injury is usually irreversible. However, prompt medical care can help prevent further damage from occurring. For this reason, it’s vital to bring a patient with TBI to the hospital as quickly as possible.

Medical providers will monitor the patient’s blood flow and help ensure the patient receives enough oxygen and maintains healthy blood pressure.

Children who have experienced neurological disabilities from TBI can also benefit from rehabilitation (rehab), such as physical and occupational therapy and psychiatric care. Rehab care can help children who have experienced TBI adapt to physical changes in their bodies and improve function at home and in social settings.