Frequency of Injury
The numbers are staggering. A half million youngsters each year are taken to emergency rooms with head injuries from falls, motor vehicle accidents, sports, and abuse. Approximately 165,000 of these children will be hospitalized with 20,000 suffering moderate to severe symptoms. These numbers are alarmingly high, in part, because of the unique characteristics of the infantile, underdeveloped brain.
Susceptibility of the Young Brain
The young brain is particularly susceptible to traumatic injuries because:
- brain neurons, and other structures and systems, are underdeveloped leaving them more vulnerable to traumatic events,
- immature brain neurons when traumatized tend to release excessive quantities of stored substances that create a toxic environment in the brain at large (excitotoxity),
- the skull segments in young children are still fusing and their skulls are much thinner, and
- a child’s head is significantly heavier relative to the rest of its body, making children more susceptible to falls that cause head and neck injuries.
Signs to Watch for in Small Children
Infants and toddlers often lack the communication or developmental skills to overtly report the signs and symptoms of brain noted below. Clinicians and families need to be aware of the following signs that may be initially observed after head trauma for this age group.
- Changes in the ability to pay attention
- Changes in eating or nursing habits
- Changes in play (e.g., loss of interest in favorite toys/activities)
- Changes in sleep habits
- Irritability, persistent crying, and inability to be consoled
- Loss of acquired language
- Loss of new skill, such as toilet training,
- Sensitivity to light and/or noise
- Unsteady walking, loss of balance
Whether children have the capacity to better recover than adults from brain injury is to some extent debatable. This involves questions of “neuroplasticity” in children and the ability of the young brain to heal itself. Further, it’s often hard to determine the full extent of any brain damage in children until later when they “grow into their injury.” Until the child gets older and faces increased cognitive expectations and new social challenges, the reality of any brain damage may not be fully known.
To learn more about traumatic brain injuries in children see the featured article by Charlie Waters in the Center database: Pediatric Traumatic Brain Injury. (see Navigation Bar on the right side of the page)