Understanding Pediatric Head Trauma

Introduction

Head trauma in kids is one of the leading causes of disability and death. Improper function of the brain due to any trauma caused by forceful blows to the head is head trauma. Head trauma is also known as brain injury, or traumatic brain injury (TBI). It may or may not require hospitalization. This article will delve into various aspects of pediatric head trauma including its type, diagnosis, treatment, and various complications associated with head trauma in kids.

What Are the Types of Head Trauma?

Head injuries can be classified as:

• Internal Injury: Injury to the scalp.

• External Injury: Injury to blood vessels, brain, and scalp.

Based on the type of injury, it is classified as:

1. A Concussion: Concussion is a mild type of brain injury or trauma that causes instant loss of consciousness or alertness or awareness for a few minutes or hours after a blow on the head or any traumatic incident. Chemical changes in the brain can happen after a concussion which sometimes can cause brain injuries.

2. A Contusion:In simple words, a contusion is a bruise to the brain. It may result in brain bleeding and swelling at the site of trauma or on the opposite side due to the brain hitting the skull. It is a serious type of brain trauma and most likely happens on the scalp and forehead.

3. Skull Fractures:Results from breaking of the skull. Following are the four types.

• Linear Skull Fractures: Crack in the bone without malalignment. Specific treatment is not required. Children are under observation and can start normal activities again in a few days.

• Depressed Skull Fractures: A crack in the bone may not be present, but the skull looks pressed or sunken. If the brain is squeezed due to pressing by the skull, surgical treatment will be required.

• Diastatic Skull Fractures: Common fractures in newborns and infants. Occurs along the suture line, which leads to the widening of the suture lines.

• Basilar Skull Fractures: A serious type of skull fracture. Involving a crack in the bone at the base of the skull. Bruising in the eye and behind the ear and clear liquid draining from the nose or ears can be seen associated with this type of skull fracture. Close observation of children is mandatory in the hospital.

4. Bleeding:Trauma can lead to bleeding in the brain and from the scalp.

What Are the Causes of Head Trauma?

Sports injuries, falls from riding bicycles or skateboarding, and accidents from motor vehicles. A high risk of head injury is seen in adolescents, most commonly affecting males. Child abuse can also cause brain trauma (shaken baby syndrome).

What Are Signs and Symptoms of the Head Trauma in Kids?

Symptoms can differ depending on the severity of the brain injury.

• Mild Head Trauma: Swollen area, bump or bruise, headache, increased sensitivity to light and noise, increased irritability, the kid may be confused, nausea, presence of light headache or dizziness, problems with balance, inability to concentrate, tinnitus (ringing sound in ears), a changed sleep pattern, altered taste, blurred vision, fatigued child.

• Moderate to Severe Head Trauma: Unconsciousness (fainting or blackouts), an intense headache that does not go away, short-term memory loss, slurring of speech, difficulty with gait (walking), weakness, pale color of skin, seizures or convulsions, behavior changes, eye changes (one pupil is larger than the other) plus the signs and symptom of mild head trauma.

What Are the Complications of the Head Trauma?

If proper treatment is not received, then life-threatening complications like the following may occur.

• Coma: Unconscious state from which a person can not be awakened is coma. The person is not responsive to stimuli, and no voluntary activities can be done.

• Vegetative State: Brain damage leads to the loss of thinking abilities and awareness but retains essential functions like breathing and blood circulation.

• Locked-In-Syndrome: When a person gets locked inside his body, it is known as locked-in-syndrome. Neurological condition in which the person is conscious and can reasonably think but cannot move the body or speak.

How to Diagnose Head Trauma?

To diagnose head trauma, a thorough physical examination is essential, assessing neurological function, vital signs, and signs of injury such as bruising or swelling. Additionally, blood tests can be performed to check for any abnormalities or markers indicative of brain injury. Imaging techniques like X-ray provide valuable insights into fractures or skull damage, while advanced tools such as magnetic resonance imaging (MRI) and computerized tomography (CT Scan) offer detailed views of the brain, enabling identification of hemorrhages, contusions, or other structural abnormalities. In some cases, an electroencephalogram (EEG) may be conducted to evaluate electrical activity in the brain, aiding in the diagnosis of seizures or brain dysfunction associated with head trauma.

What Are the Treatment Options Available?

Call the doctor immediately if the infant does not stop crying, is fussier, vomits more than once, does not wake up, is not walking normally, or does not soothe easily. (infants cannot easily convey the problems they are facing, so keep a close eye on symptoms).

Depending on the severity of the injury, treatment can be decided; it includes:

• Ice: Icing the injured area with ice wrapped in a cloth or sock for 20 minutes every three to four hours can reduce the swelling.

• Rest: Ensure that the child is adequately rested.

• Apply topical ointment and bandage if essential.

• Observe the Child Closely: 24 hours are very important after the injury. If the injury happens near bedtime, check a few times. Reach out to the hospital if it is necessary. In some cases, stitches may be required. Surgical intervention is necessary in some cases.

• Follow the Doctor's Advice: The doctor will provide the best treatment depending on the child's age, medical history, how aggressive the symptoms are, what medications to be prescribed, any need for surgery, and how much day observation is required. Severe brain trauma can result in loss of speech, hearing loss, muscle loss, and altered taste, depending on the area of brain damage. These children will require medical and rehabilitative care lifelong. Parents should wait until the doctor gives a green signal to play sports.

• Go With the Instincts: If parents feel the child does not look fine, they should not waste time and rush to the hospital.

How can Parents Ensure Children’s Safety?

Providing a safe environment can prevent head injuries in children. This can be achieved by wearing car seat belts, helmets on motorcycles, bicycle riding, and skateboarding. Make children learn the importance of safety rules and ensure they follow them. The extent of child recovery after brain trauma depends on the severity of the trauma and other problems, so the parents must be supportive and teach positive reinforcement to encourage the children.

Conclusion:

Brain injuries can cause lifelong disabilities. Most children with mild head trauma are discharged from trauma or emergency units. Few cases need hospitalization for observation and treatment. Injury-proofing a child is not possible, but a few simple steps can prevent head trauma. After the injury, it is crucial to focus on increasing the child's capacity at home and in society by encouraging self-esteem and promoting independence.