11/8/2016 Little Brains, Big Future: The Impact of Traumatic Brain - - PDF document

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11/8/2016 Little Brains, Big Future: The Impact of Traumatic Brain - - PDF document

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11/8/2016 Little Brains, Big Future: The Impact of Traumatic Brain Injury in Young Children Ashley Graves, Project Development Specialist Center for Safe Schools / Pennsylvania Safe Kids Mission Statement Traumatic Brain Injury (TBI)

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Little Brains, Big Future: The Impact of Traumatic Brain Injury in Young Children

Ashley Graves, Project Development Specialist Center for Safe Schools / Pennsylvania Safe Kids

Mission Statement

  • Traumatic Brain Injury (TBI) impacts

cognitive, physical and affective domains

Objectives

  • Understand the mechanism of injury
  • Recognize the signs and symptoms

associated with TBI

  • Learn how the young brain is more

susceptible to TBI

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Statistics

  • CDC Reports:

– Estimates 1.7 million people sustain a TBI every year – 473,947 ED visits, 2,685 deaths, 37,000 hospitalizations (children 0-14) for TBI annually – Each year an average of 62,000 children sustain brain injuries requiring hospitalization as a result of motor vehicle crashes, falls, sports injuries, physical abuse and other causes (children 0-19)

Traumatic Brain Injury (TBI) Causes

  • Bump
  • Blow
  • Jolt
  • Penetrating head injury

Polling Question

  • At what age have all the brain sutures

closed

– 3-9 months of age – 5-10 months of age – 15-18 months of age – 22-39 months of age

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Basic Anatomy Brain Anatomy Cont. Polling Question

  • At what age is the brain fully developed?

– 13 years of age – 18 years of age – 21 years of age – 25 years of age – 27 years of age

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Brain Lobes

  • Frontal
  • Parietal
  • Occipital
  • Temporal

Memory

  • Short-term
  • Long-term
  • Skill

Mechanism of Injury

  • Falls from any distance
  • Falls while standing, walking, or running
  • Collisions with a stationary object when

walking or running

  • Motor vehicle crashes
  • Bicycle crashes
  • Child abuse
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Coup vs. Contrecoup Rear-facing vs. Forward-facing Rear-facing vs. Forward-facing

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Polling Question

  • How many states have a law that pertains

to rear-facing car seats?

– 4 – 15 – 32 – 50+ D.C., Guam, Northern Mariana Islands, Puerto Rico, and U.S. Virgin Islands.

Concussion/Mild Traumatic Brain Injury

  • Concussion – a form of mild traumatic

brain injury (mTBI)

  • Disruption in normal brain function
  • Trauma induced alteration in mental status

Severe TBI Types

  • Closed
  • Penetrating
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Severe TBI

  • TBI contributing factor to 30.5% of all

injury-related deaths in the U.S.

  • Non-fatal severe TBI may result in

extended period of unconsciousness (coma) or amnesia after injury

  • Hospitalized after TBI – 43% have

related disability one year after injury

CDC, 2012; 2015

Physical Symptoms

  • Headaches
  • Crying
  • Inability to be

consoled

  • Restlessness
  • Nausea
  • Vomiting
  • Change in nursing
  • r eating habits
  • Light sensitivity
  • Dizziness
  • Fatigue
  • Drowsiness
  • Noise sensitivity
  • Balance problems
  • Visual problems

Cognitive Symptoms

  • Feeling mentally foggy
  • Difficulty concentrating
  • Problems remembering
  • Difficulty problem solving
  • Short term memory loss
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Emotional (Affective) Symptoms

  • Irritability or increase temper tantrums
  • Sadness or becoming upset easily
  • Depression
  • Anxiety
  • Nervousness
  • Feeling overall more emotional

Sleeping Symptoms

  • Drowsiness
  • Sleeping more or less than usual
  • Insomnia
  • Trouble sleeping or falling asleep

Post-TBI Difficulties

  • Concentration, attention span
  • Headaches
  • Visual scanning
  • Irritability or change in attitude
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Red Flag Symptoms

  • Excessive crying
  • Change in sleep

pattern

  • Will not nurse or eat
  • Loss of consciousness
  • Seizures
  • Cannot stay awake
  • Repeated vomiting
  • Increased irritability
  • Slurred speech
  • Lacking recognition of

people or date/place

  • Increasing confusion
  • Unusual behavior

change

  • Worsening/Persistent

headaches

  • Ringing of ears

Management Team

  • Determination of appropriate therapy and

recovery options

  • On-going communication between all

members Team Members

  • Caregivers
  • Daycare provider(s)
  • Pediatrician/Primary care physician (PCP)
  • Neurologist
  • Speech pathologist
  • Occupational Therapist
  • Physical Therapist
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Treatment

  • Rest
  • Medication
  • Environment management
  • Minimize visual scanning

Recovery

  • Depends on history
  • Mild TBI should clear in 2-3 weeks
  • Short-term & long-term consequences
  • Can be life-altering

Child vs. Adult

Child

  • Less muscle mass
  • Head proportion to

body

  • More vulnerable
  • Longer recovery
  • More symptoms
  • Unconsciousness is

very uncommon

Adult

  • Less vulnerable
  • Shorter recovery time
  • Less symptoms
  • Unconsciousness is

more common

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Prevention of TBI

  • Wearing seat belt or using a properly fitted

and installed child passenger safety seat

  • Wearing properly fitted protective

equipment (ex. Helmet)

  • Playground surfaces are made with shock-

absorbing materials

  • Making living areas safer

Prognosis

  • People with history of concussions are

more susceptible to another one

  • Repeated TBIs may increase risk of

developing dementia, CTE, Parkinson’s disease and depression later in life. (Covassin,

Stearne, Elbin, 2008).

Polling Question

  • Second Impact Syndrome occurs when an

individual experiences a second blow within the same day.

  • True or False
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Second Impact Syndrome

  • Suffering a second collision before

completely healing

  • Resulting in death, severe TBI or

prolonged recovery from initial injury

  • Loss of cerebral auto regulation of

vascular control Chronic Traumatic Encephalopathy (CTE)

  • Progressive degenerative brain disease
  • People with history of repetitive

brain trauma

BRAIN BANK

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Post-Concussion Syndrome (PCS)

  • Symptoms do not resolve for weeks,

months or years

  • No scientific protocol to treat condition
  • Typically symptoms subside within a few

months

Neuropsychological Testing

ImPACT

  • Used in medical field for management of

concussions

  • Computer based assessment of cognitive

functioning

ImPACT Results

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References

Centers for Disease Control and Prevention www.cdc.gov/TraumaticBrainInjury/index.html Brain Anatomy, Mayfield Clinic www.mayfieldclinic.com/PE-AnatBrain.htm#.Va1B4PlVhHw www.swata.org/statistics www.brainline.org www.biausa.org

Contact

Ashley Graves

Project Development Specialist Center for Safe Schools / Pennsylvania Safe Kids (717) 763-1661 ext. 131 agraves@csc.csiu.org