Acquired Brain Injury
Causes
The common causes of paediatric brain injury in Australia are:
- Motor Vehicle and bike accidents
- Falls
- Sporting injuries
- Meningitis/encephalitis (infections around the brain)
- Cerebrovascular accidents (stroke)
- Hypoxia (lack of oxygen to the brain) from near-drowning accidents, cardiac (heart) causes and prolonged fits.
- Non-accidental injuries
Classification
Brain injury can be classified as focal or diffuse injury.
Focal injury usually occurs following a direct blow to the head, causing a skull fracture. There is often bruising to the brain underlying the fracture.
Diffuse injury is often as a result of a motor vehicle accident or falls where there has been shaking of the brain. This results in damage to the connections between nerve cells, termed diffuse axonal injury. The damage is more widespread than focal injury and therefore there may be more problems.
Severity
It takes time to tell how serious the brain injury is and what long term effects there may be. The most reliable way to assess the severity of injury is to measure the amount of time the child/young person is in post traumatic amnesia (PTA). This is the period of time the child/young person remains confused, disorientated and has poor day to day memory.
The other ways to assess the severity of injury include the Glasgow Coma Score Scale (GCS) and the length of coma. The GCS is used to assess the level of coma by checking how well a child/young person can respond to commands. Coma is when the brain is not functioning at its normal level, as the part of the brain responsible keeping us aware of what goes on around us is affected. During this time the child/young person may have difficulty communicating or responding to light, sound or touch.
Effects of the brain injury
Following a brain injury there may be changes affecting physical function, cognition (thinking), personality, behaviour and communication.
The short term effects include coma (being unconscious) or concussion (being drowsy and confused). In the longer term, physical problems include weakness, poor balance or co-ordination, and fatigue. Cognitive effects can include reduced attention and concentration, difficulties with memory and new learning, with planning and organisation, changes in behaviour and changes in communication such as expression and understanding what is said.
Recovery
It is important to note most problems improve with time. Getting better after a brain injury happens at a different rate for every child/young person but usually continues for a long time. The recovery is most rapid in the early stages. Most children who have sustained a very severe brain injury will have some degree of cognitive, physical or behaviour deficits. The rehabilitation team will work with the child and family to maximise the recovery.
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