Children can be born with conditions which have caused brain injury during gestation – or brain injury sadly can sometimes occur during delivery.
Acquired traumatic brain injury (TBI) is also a common result for both children and adults who are involved in accidents in which they suffer a head trauma on impact – this might be in a sports accident or a road traffic accident (RTA).
It can be very difficult to pinpoint the causes of congenital brain injuries in children, some of which might have resulted from adverse events during pregnancy or might be genetic.
One of the most common causes of brain injury at birth is oxygen deprivation (asphyxia) and this can occur if birth is delayed or the umbilical cord become wrapped round the baby’s neck.
Some of the main causes of brain injuries to children include:
Birth defects leading to brain injury
- Asphyxia (lack of oxygen in the womb or during delivery)
- Genetic defects (an inherited condition passed down the family)
- Infections (mother suffers infection passed through the umbilical cord eg rubella)
- Neural tube defects (the neural tube connecting the spine and brain does not develop properly resulting in conditions like spina bifida)
- Stroke in utero (baby suffers brain haemorrhage while in the womb)
- Trauma (eg physical assault or impact).
Babies who do suffer an adverse event in the womb – or whose mothers may be ill or involved in an accident – will not always be born with brain injury; but some adverse events such as oxygen deprivation in the womb or during birth, or a neural tube defect, will make this more likely.
Serious conditions which affect the foetus may result in miscarriage or stillbirth. The neural tube defect anencephaly means that the brain does not develop at all and stillborn babies are sometimes found to have suffered this defect in the womb.
Anencephaly occurs when the neural tube leading from the spine does not seal at the end where the brain should grow – and therefore the “instruction” for the skull which protects the brain and the brain itself to grow is not transmitted, leaving just the brain stem at the end of the spinal column.
Few babies will survive this brain defect, but one baby in the US, Nicholas Coke, has survived past his first birthday. Anencephaly usually affects girls more than boys and often stillborn baby girls are found to have suffered anencephaly during a post-mortem.
Brain injury can also occur postnatal – especially if a baby needs medical treatment after delivery and complications arise. Many babies survive heart surgery well, but conditions such as stroke can flood the brain with blood and cause severe brain injury.
Medical negligence in which babies are left without an oxygen supply for a period is another commonly reported cause of brain injury in children – this is still very rare, but because of the catastrophic brain injuries which oxygen deprivation (asphyxia) can cause, claims for compensation in such cases can end in the NHS or private clinics having to pay out millions of pounds via their insurers.
Accidents are the most common cause of brain injury in children – and once babies begin to crawl, parents need to be extra-watchful, as blows to head can occur and not even leave a mark, although concussion and underlying brain injury such as a blood clot might have resulted.
Concussion is classed as mild, moderate and severe and usually involves symptoms of
- loss of memory
- problems with speech or remembering vocabulary or details
- sight and hearing disturbances
Even mild concussion needs to be reported to a doctor and monitored for a week or so after the injury, as concussion can sometimes develop into more serious brain injury if a small blood clot has formed or a second concussion occurs if a patient falls or hits their head again.
A scan can detect blood clots, so your GP may recommend that you take your child to the nearest A&E after a blow to the head.
If your child exhibits symptoms of vomiting, losing consciousness, and has blood or clear liquid in their ears or nose, then medical help should be sought immediately.
Incidents which may result in head/brain injury in children include:
- Falls from height – windows or balconies
- Leisure centre accidents – swings, climbing frames
- Riding accidents – on holiday or at home
- Road traffic accidents – cars, motorcycles, quad bikes, scooters, bicycles
- School playground accidents – fights, trips, slips and falls
- Sports accidents – blow to the head from balls and bats
- Swimming accidents – drowning causes oxygen deprivation which may result in brain injury if the child survives.
Sadly some children suffer brain damage if they are allowed to drink alcohol or access drugs, take over-the-counter medications, or drink or sniff cleaning fluids or aerosols.
Parents need to be vigilant at all times with their children – and be aware that peer pressure among youngsters can make them indulge in risky behaviour which would normally be out of character.
The charity Headway offers support to families whose child has suffered acquired traumatic brain injury or a brain defect at birth.