Kids Health Info

Acquired brain injury (ABI)

  • There are many different causes of brain injury including traffic accidents, sports accidents or lack of oxygen to the brain. It takes a long time to work out how serious a brain injury is.

    One way is to measure how long after the injury your child is in 'post traumatic amnesia', which is the time after the injury they are confused, disorientated and have poor day to day memory. Each child's recovery will be different and take different lengths of time. Recovery usually continues for many years after the injury.

    Causes

    The most common causes of brain injury in Australia are:

    • Traumatic brain injury (from falls, motor vehicle accidents, sports).
    • Meningitis/encephalitis (infections around the brain).
    • Cerebrovascular accidents (or strokes) which can be caused by arteriovenous malformations or cardiac complications.
    • Hypoxic-ischaemic events caused by a lack of oxygen to the brain. These can be due to near drowning accidents, prolonged fits or cardiac complications.

    Classification

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

    Focal Injury

    Focal injury usually happens after a direct blow to the head, causing a skull fracture. There is often bruising to the brain below the fracture.

    Diffuse Injury

    Diffuse injury often happens after a motor vehicle accident or a fall, where the brain has been shaken. This causes damage to the connections between nerve cells. This is called 'diffuse axonal injury'. This type of damage tends to be spread across a larger part of the brain than a focal injury. Because a larger part of the brain is damaged, it means there may be more problems.

    Severity

    Post traumatic amnesia (PTA)

    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 the injury is to measure how long your child is in post traumatic amnesia (PTA). This is the time after the injury when they are confused, disorientated and have poor day to day memory.

    Glasgow Coma Scale

    Other ways to assess how serious the injury is 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 your child can respond to commands. Coma is when the brain is not functioning at its normal level, because the part of the brain that is responsible for keeping us aware of what is going on around us is affected. During this time your child may have difficulty communicating or responding to light, sound or touch.

    Effects of the brain injury

    After a brain injury your child may have changes to their physical function, cognition (thinking), personality, behaviour and way they communicate.

    The short-term effects include coma (being unconscious) or concussion (being drowsy and confused). Longer term effects may include weakness, poor balance, poor coordination and fatigue. Cognitive effects can include problems with attention and concentration, difficulty in planning and organisation, changes in behaviour and changes in communication such as having problems with expression and understanding.

    Recovery

    The rate of recovery is different for each individual. Recovery usually continues for several years following the injury but is usually most rapid in the early weeks to months afterwards. The rehabilitation team - made up of doctors, nurses, occupational therapists, physiotherapists and a neuropsychologist - will work with your child and family to maximise their recovery.

    Key points to remember

    • After a brain injury there may be changes that affect your child's physical function, cognition (thinking), personality, behaviour and communication.
    • The recovery rate is different for each child and usually continues for many years.

    For more information

    Developed by the RCH Paediatric Rehabilitation Service. Based on information from the Brain Injury Service, at Westmead Children's Hospital (with permission). First published Nov 2006. Updated September 2012.


Disclaimer 
This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital, Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.