Traumatic brain injury in children is caused by an external force that can bring about a decreased or altered level of consciousness and alter cognitive abilities, behaviour and physical functioning. The most common causes of childhood head trauma are car accidents, falls and interpersonal violence. They can also sometimes be caused by a diffuse axonal injury as a result of the high-speed coup-contrecoup impact that the brain receives when it suffers an injury. Diffuse axonal injury is when fibres in the cerebral white matter break down. The following can occur both at the time of impact and after different periods of time:

• Intracerebral haemorrhages.
• Cerebral oedema.
• Ischaemic lesions.
• Infections.
• Hydrocephalus: This is one of the most frequent complications due to the excessive accumulation of cerebrospinal fluid in the brain. Cerebrospinal fluid is the liquid around the brain and spinal cord. If a doctor suspects a case of hydrocephalus, the patient is monitored by an ICP sensor, which measures intracranial pressure. If hydrocephalus is confirmed, a shunt valve is put in place to drain excess fluid and relieve pressure on the brain.
• Post-traumatic epilepsy: This disorder is characterised by seizures that manifest some time after having suffered a head injury. For this reason, antiepileptic drugs are often prescribed after a traumatic brain injury to prevent seizures.
• State of coma: A coma is a pathological state characterised by unconsciousness that is resistant to external stimuli. A state of coma is not a disease in itself, but a syndrome. In other words, it is the expression of an underlying disease that can be treated.

Traumatic brain injuries in children are a common reason for attending an accident and emergency department. Although most do not lead to serious consequences, traumatic brain injuries are the main cause of death and disability in children older than 1 year in developed countries. It is estimated that 1 in 10 children will have a significant traumatic brain injury throughout their childhood. In these cases, a personalised assessment is needed to come up with the most appropriate treatment plan.

Sequelae of a traumatic brain injury

The most common cognitive, behavioural and emotional impairments after a traumatic head injury are attention deficits, language disorders, memory problems, executive dysfunction, and behavioural and mood disorders.

• Neuropsychological disorders
• Impaired movement capacity
• Sensory problems
• Communication problems

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