“How do you make a tissue dance? Put a little boogie in it.” As evidenced by my “dad jokes,” in addition to my role as a pediatric neurosurgeon, I am also a proud father to three amazing children.
My family and I have always bonded over our love of horses. My youngest, in fact, is quite the accomplished equestrian. And while I am endlessly proud of each of them for their dedication to and care for our horses, I take even more pride in the fact that neither they — nor I — have ever been on any horse without putting on a helmet first. Period.
Brain injuries in babies, children and teens are a significant issue. According to the Centers for Disease Control and Prevention, not counting individuals over age 75, the age groups with the highest risk of traumatic brain injury are young children aged 0-4 and adolescents aged 15-19. In 2024, Phoenix Children’s had more than 140,000 emergency department visits, more than 2,300 of which were trauma visits.
March is Brain Injury Awareness Month, a time to dig into how and why brain injuries occur, types of TBI, what to do if one should happen to your child and how to prevent them in the first place.
There are two primary types of TBI in children — penetrating and non-penetrating.
A non-penetrating (aka “closed head” or “blunt”) TBI occurs when an outside force — usually from a fall, car accident or sports injury — is strong enough to move the brain around inside the skull. The result of a non-penetrating brain injury can be a brain contusion (bruise), concussion, bleeding in and around the brain and/or skull fracture.
A penetrating TBI occurs when a projectile pierces the skull. This is most often the result of a firearm or accidents involving a sharp object.
Even a seemingly mild TBI can cause myriad symptoms including headaches, light and noise sensitivity, irritability, balance and concentration issues, nausea, fatigue and sleep issues. Moderate or severe injuries might mean more significant symptoms, notably long-term pain or discomfort, sustained sleep issues, slurred speech, trouble walking and — in severe cases — loss of consciousness.
When seeking medical care for a child, no matter the severity or type of brain injury that has occurred, it is critical to obtain care from a team that specializes in pediatric TBI because a child’s brain is still developing. This means even a mild TBI can cause long-term consequences in a child that will not present in an adult, whose brain is fully developed.
In the case of an emergency, the role of an emergency medical technician or paramedic is to perform an initial assessment of the injury and quickly stabilize the child and get them safely to emergency care. Therefore, EMTs will most often safely transport a child to the closest emergency department. If this is not a children’s hospital, after the child is stabilized, parents or caregivers have the right to thank the team and request transport to a medical center that specializes in pediatric care. Phoenix Children’s is the only Level I pediatric trauma center in Arizona.
Parents and caregivers should expect a series of diagnostic testing when the medical team is assessing TBI. This may include blood tests, X-rays, CT scans; MRIs and/or an Electroencephalogram to record the brain’s electrical activity. A child could need admission to the intensive care unit, and in severe cases could need neurosurgical intervention.
Mild TBI treatment may consist of ice, rest and monitoring. Observation is critical, especially for loss of muscle strength, fine motor skills, speech, vision, hearing, or taste function. The medical professional can prescribe a custom care plan that may include a variety of physical, occupational, and speech therapies. Concussion symptoms can sometimes last weeks to months.
In moderate and severe cases, additional interventions may be required, including surgery to monitor brain pressure or reduce brain swelling, inpatient rehabilitation and long-term care. Parents and caregivers should know that Arizona is home to the Frances H. McClelland Rehabilitation Program at Phoenix Children’s, the state’s only acute inpatient rehabilitation facility dedicated exclusively to pediatric and adolescent care and focused on the continuum of recovery care.
Any type of TBI to a child or teen is scary, as much for the parent or caregiver as the child. And, in many cases, these injuries are wholly preventable. Let that sink in — most of these injuries in children can be avoided in the first place.
Be diligent in prevention. Never allow a child to ride a bike, horse, skateboard/scooter, ski/snowboard or play a contact sport without a helmet. What’s more: never do it yourself. Helmets are not a case of “do as I say, not as I do.” The same goes for seat belts and other protective gear. Educate your child in safe play, and make sure they understand that any injury is worth reporting to you.
In addition, proper car or booster seats are critical. There are free services, including at Phoenix Children’s and elsewhere in the community, to help parents and caregivers with proper sizing and installation.
Finally, I cannot overstate the importance of proper firearm safety protocols. If there is a firearm in the home, it should always be locked and unloaded, with ammunition locked away separately.
Brain injuries can have devastating long-term consequences for the entire family. Prevention is key to keeping your children and your family safe and avoiding tragedy.
Editor’s note: Jason S. Hauptman, MD, PhD is a pediatric neurosurgeon, division chief of pediatric neurological surgery and the Caroline Hoeye Endowed Chair in Neurosurgery at the Barrow Neurological Institute at Phoenix Children’s. Please send your comments to AzOpinions@iniusa.org. We are committed to publishing a wide variety of reader opinions, as long as they meet our Civility Guidelines.
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