When your child sustains a brain injury, it can be frightening. Nearly 5.3 million Americans have a disability resulting from a traumatic brain injury (TBI), and for children, TBIs are the most frequent cause of death and disability, according to the Tennessee Disability Coalition.

Children who have sustained a TBI may have unique needs. If your child comes through Le Bonheur’s Emergency Department (ED) and is diagnosed with a TBI, they can benefit from Project BRAIN --  a resource and information network for those (educators, families health care workers, etc.) who support Tennessee students with a TBI. The program is sponsored by the Tennessee Disability Coalition, and Nikeisha Royston serves as Le Bonheur’s brain injury transition liaison. She and Project BRAIN's Sarah Sampson have helped us answer the questions below.

What is a traumatic brain injury, and when should I take my child to the hospital if he has hurt his head?
According to the Centers for Disease Control and Prevention, a TBI is caused by a bump, blow or jolt to the head or a penetrating head injury that disrupts the normal function of the brain. Not all blows or jolts to the head result in a TBI.

The severity of a TBI may range from mild (a brief change in mental status or consciousness) to severe (an extended period of unconsciousness or amnesia after the injury). The majority of TBIs that occur each year are concussions, which can occur from a fall or a blow to the body that causes the head and brain to move quickly back and forth. Concussions are considered to be a mild TBI because they are usually not life threatening, but the effects can still be dangerous.

Making the decision to take a child to the hospital is a parent or guardian’s call.  If parents are unsure whether to take their child to the emergency department, they could first call their primary care physician, explain the concern and follow those recommendations.

Here are some of the signs and symptoms to watch for if your child has hurt his head. Remember that symptoms don’t always present right away, so keep a careful watch for the following:

• Headaches (including a recurring headache, pain in and around the eyes, jaw or ear)
• Dizziness or trouble balancing
• Sensitivity to smells or changes in taste or smell
• Appetite changes
• Bothered by noises or a ringing in their ears (or can’t handle normal background noise)
• Blurry vision (or seeing double)
• Sleeping too much (or can’t sleep through the night)
• Mood swings (or is irritable or anxious)
• Change in personality or behavior
  

For a complete list of signs to watch for, visit the Project BRAIN website.

How will patients and their families benefit from being connected with Project BRAIN?
Project BRAIN has partnered with prominent regional children’s hospitals including Le Bonheur to implement the Brain Injury Transition Liaison (BITL) process and better serve children who sustain a TBI.

When a patient is seen in Le Bonheur’s ED and is diagnosed with a TBI, the physician will designate this in the medical record. At discharge, the child’s parent or guardian will receive information about TBIs and Project BRAIN’s efforts to educate the community about brain injury and the potential impact an injury may have on a student’s learning.

Depending on the wishes of the parent, Project BRAIN can follow up with the child’s school and family to support the child's transition back to home and school following a TBI.

As the brain injury transition liaison, my role is to serve as the communication link between the hospital, home and school to support students with a TBI. I educate health care professionals about the students’ experiences beyond hospital doors and provide support to the family through three follow-up phone calls in the first six months following an injury. I also share valuable resources with families and how to access them, if necessary. 

Dr. Barry Gilmore, Medical Director of Emergency Services at Le Bonheur Children’s Hospital gives parents some helpful tips on head injuries and the danger signs to watch for.

“Most often, children come to Le Bonheur with head injuries resulting from accidents that happen around the house or during an activity. Usually, complaints range from a headache, dizziness or even sometimes, no symptoms at all. Dr. Gilmore warns parents that head trauma is never something to take likely or try to wait out. If you have an uneasy feeling about an accident or injury, it’s always best to get your child into your pediatrician’s office or the emergency department.

Two of the biggest warning signs parents need to watch for after a head injury are loss of consciousness or vomiting. If your child is experiencing either of these, contact your pediatrician immediately. Other worrisome symptoms range from confusion, dilated pupils, loss of coordination or complaints of head pain.

The number one cause of head trauma seen across the country usually occurs from falls. Other causes range from motor vehicle accidents, sports activities and accidents during play. “If your child is participating in any activity that could produce a head injury, make sure you are taking all the safety precautions required to prevent that from happening,” says Dr. Gilmore.

The No. 1 safety precaution parents can take is making certain that your child is always buckled in his or her seatbelt or strapped into a car seat. This rule has no exceptions.  “If this rule was followed at all times we could prevent almost all of the head injuries we see resulting from vehicle accidents,” Gilmore said. “Buckling in your child needs to be the first thing you do in your car before you ever back out of the driveway.”

Helmets are also essential necessities for protection on bikes, scooters and skates. Parents can visit any sports store to purchase a good helmet. Read the instructions to make sure the helmet fits the child appropriately. It’s also a good practice to buy the elbow and knee pads as well.

Doctors at Le Bonheur Children’s Hospital in Memphis see head traumas quite regularly. Dr. Gilmore stresses to parents that accidents are going to happen. The best thing you can do for your child is to make certain he or she is taking the appropriate safety precautions when participating in sports activities or riding in a vehicle. Outside of that, if you have a bad feeling or your child exhibits any of the warning indicators listed above, don’t hesitate to contact your pediatrician.”