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babydummyMost children have scrapes and knocks during childhood and school activities –  and recognising the symptoms of conditions like concussion  can help parents make the right decision about whether to see a GP or take your child to A&E.

Some children are also born with brain injury or sadly suffer brain injury at birth – and understanding what is happening in the brain can help parents, family and friends communicate with a brain-injured child and recognise what their needs may be.

Brain injury ranges from mild concussion to catastrophic brain injury, either from a mismanaged birth, adverse event during gestation or delivery – or as the result of an accident or event after birth (acquired traumatic brain injury or acquired TBI).

The degrees of concussion can also range from mild to moderate or severe – and although concussion may seem like a temporary condition, if an underlying symptom such as a blood clot develops after a blow to the head or fall, then concussion can mean the patient’s condition deteriorates rapidly.

The symptoms of brain injury generally are:

  • Abnormal gait and problems walking
  • Abnormal movements in limbs
  • Facial paralysis or facial palsy (as in Bell’s palsy)
  • Hearing and sight impairment, including deaf blind conditions
  • Lack of speech or impaired speech
  • Learning difficulties.
  • Physical disability
  • Trembling, shaking and palsy (as in cerebral palsy)
  • Slow development in babies and children.

If brain injury occurs following a blow to the head or an adverse event such as oxygen deprivation during a swimming accident or even surgery, the symptoms of brain injury may be:

  • Blackouts
  • Blood or clear liquid in nose or ears
  • Headache and pain
  • Lack of consciousness
  • Listlessness
  • Memory loss
  • Problems standing or walking
  • Paralysis
  • Palsy and trembling limbs or lack of control over limbs
  • Shouting and/or swearing irrationally
  • Speech difficulties, including loss of vocabulary or jumbled speech
  • Writhing or stiff limbs
  • Vomiting.

Brain injury which results from an accident – eg concussion – can be temporary. Other causes of brain injury include events such as strokes – when a blood clot may form and flood an area of the brain.

When an individual appears to have suffered trauma to the head, an adverse event such as stroke or heart attack, or an accident or incident in which they were deprived of oxygen, it is vital to seek medical help immediately. The hour following a stroke is known as the golden hour by medics, because patients who are treated with clot busting drugs within an hour of a stroke have been found to suffer fewer side effects, including fewer mobility issues and speech problems.

The effects of brain injury on an individual are caused by a break in communication between the white brain matter, which contains cells called neurotransmitters – and grey matter which contains cells storing information, memories and motor skills such as walking, talking, movement and coordination.

Depending on which part of the brain suffers injury, messages sent out by the neurotransmitters cannot be processed properly by the cells in the brain’s grey matter, which acts as a databank. This means that although a child or adult with brain injury knows what they want to do or say, the messages from the brain telling their body to do it do not get through.

Neuroscientists such as Professor Adrian Owen, who investigates “locked in syndrome” among brain damaged patients, have found that even a severely brain injured individual may be able to store new memories, be aware of what is happening around them – and their brains may even be able to respond to external instructions to move their bodies; but none of this mental activity is apparent to the onlooker, who may feel the patient is in a persistent vegetative state and has no awareness of their surroundings.

This can explain why patients with brain injury who do display activity and cognitive skills can become incredibly frustrated and feel isolated. Your loved one may be firing on many cylinders internally – but the messages their brain is sending out do not reach the target area of the body to enable them to speak, walk, move or even visibly react in some cases to what is going on around them.

cerebralpalsytoddlerChildren with brain injury – eg cerebral palsy – usually appear slower in their development than their peers. Catastrophic brain injury in children results in very obvious symptoms, some of which may become more apparent as doctors and therapists begin working with the child. Brain injury which is less evident may take time to diagnose and evaluate – and usually doctors will carry out MRI and CT scans to confirm the extent of brain injury in a child who may have cerebral palsy or another birth defect affecting their brain.

In the case of acquired traumatic brain injury, children’s brains can be remarkably adaptive when it comes to learning new skills – young brains are endowed with the ability to assimilate information quickly because they have neuroplasticity, a quality older brains lose as they age: it is as though new information and memories are literally imprinted on young brains.

Brain injury therapies often involve daily repetition to learn or relearn skills and information – and the brain is able to adapt after brain injury and frequently another part of the brain will slowly take over the function which has been lost in the injury.

Getting a diagnosis as soon as you suspect your child is not developing as quickly as they should can help both your child and the family adapt and make progress together in dealing with the situation.

As your child grows there will times when they feel frustrated with their own progress – but many children with brain injury lead happy and fulfilling lives and develop new skills throughout their lives, even if this take a little longer than even they themselves would like

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