What are the chances of getting TBI after a fall?

Question

Hi doctor,

The other night, my 13 months old daughter started screaming like crazy, I ran and picked her up and tried to walk around the room to soothe her, and I accidentally slipped while holding her and she fell on the floor. As I was slipping, I fell knee first, and at that point in that microsecond, I realized I do not want to fall on my daughter, so I let her go and put my arms in front of me. So I do not think she fell from two meters, but I did hear a bang as if a tiny head touched the floor (wooden floor without a rug). She started crying a lot after this for about 3 to 4 minutes, and then she went back to sleep. The next day I looked for visible signs, no vomiting, no cross eyes, but she did feel just a bit less playful and more lethargic than usual. I know that this is not an easy answer, and I am not just looking for reassurance. But my question basically is, what are the chances that the trauma she had to her head was a TBI (traumatic brain injury)? Is it possible that this will have long-lasting effects on her learning skills or abilities?

Answer 1

Hi, Welcome to icliniq.com.

I understand your question. There are two ways of judgement in our practice. Clinical judgement. Evidence-based judgement. The clinical one is based on the history, which you gave me. I appreciate the detailed description of the mode of injury and symptoms. Based on that, what I feel is that she had a mild traumatic brain injury, that is concussion brain. That means her brain was shaken up significantly and as a result of that, she was bit lethargic later on. Rest assured, a single mild concussion at the age of 18 months will not have any negative effect on her brain development and brain function. It has effect if it happens frequently, there are very fewer chances when it has happened just once and that too mild concussion. Now, this was my clinical judgement, I am pretty sure about it. If we want to go for evidence-based judgement, then we need her brain scan, just to make sure that everything is fine with her brain. Though very less likely in this case, the child can develop hematoma within the skull without many symptoms. You can get CT (Computed Tomography) or MRI (Magnetic Resonance Imaging) of the braindone and get the report. With the current standard of practice, we prefer to have evidence-based decisions. I hope my answer helps.