Please note that this website is currently being merged into the Sydney Children's Hospitals Network website. As such, the content on this site is not guaranteed to be correct. Please visit our new website for the most up to date content. Thank you.
The Children's Hospital at Westmead
About us Parents Children Professionals Research eShop
search our site
feedback     sitemap
  gap for health
  outpatient speciality clinics
kids Rehab
  Brain Injury
    About Brain Injury
      Information Sheets
      The Team
    Inpatient Services
    Outpatient Services
  nursing clinical placements
  simulation centre
  GP resources
  elective admissions

Acquired Brain Injury

Disclaimer: This information sheet is for education purposes only. Please consult with your doctor or other health professional to make sure this information is right for your child.


The most common causes of brain injury in Australia are:

  • Motor vehicle and bike accidents
  • Falls
  • Sporting injuries
  • Meningitis/encephalitis (infections around the brain)
  • Cerebrovascular accidents (stroke or haemorrhage/bleeds) see arteriovenous malformation
  • Hypoxia (lack of oxygen to the brain) from near-drowning accidents, cardiac (heart) causes and prolonged fits.


Brain injury can be classified as focal or diffuse injury. A child can have both injuries as a result of trauma.

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.


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 following the injury.

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. See stages of recovery.

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 coordination, and fatigue. Cognitive effects can include reduced attention and concentration, difficulty in planning and organisation, changes in behaviour and changes in communication such as expression and understanding.


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 several years. The recovery is most rapid in the early stages (weeks to months). The rehabilitation team will work with the child and their family to maximise the recovery.

The Children's Hospital at Westmead Rehabilitation Department
The Children's Hospital at Westmead
Cnr Hawkesbury Rd & Hainsworth St, Westmead
Locked Bag 4001, Westmead, 2145
Tel: (02) 9845 2132 - Fax: (02) 9845 0685

© The Children's Hospital at Westmead - 1997-2013

This document was published on Friday, 6 June 2003

  table of contents copyright    disclaimer    privacy