TRAUMATIC BRAIN INJURY
Resources for post-traumatic brain injury / concussion.
Where a child has sustained a blow to the head and appears concussed or groggy, it is recommended they be taken to the local Emergency Department for assessment. An assessment tool called the Glasgow Coma Scale is invaluable for clinicians who may later be asked to assess for a brain injury. Emergency Departments rarely if ever use this scale, which is a best practice assessment for use on intake, whilst admitted, and before discharge. Parents may like to request that one is done by a suitably qualified person (typically a Doctor, Occupational Therapist, or Paramedic), and request a copy of the results. Keep this so that if needed in future, a copy can be provided to the assessing clinician. The NZ best practice guidelines advise that Paramedics and ED departments should:
- Use the GCS to assess people with a head injury.
- The risk of intracranial complications and consequent need for surgery increases as
the GCS declines.
- Urgent investigation and/or referral is indicated if there is a fall of ≥ 2 points in the
- GCS, as this may represent the development of intracranial bleeding.
From: Traumatic Brain Injury: Diagnosis, Acute management, and Rehabilitation. Evidence-based Best Practice Guidelines Summary: New Zealand Guidelines Group, 2007. ACC: Wellington.
The following websites provide some useful information on concussion and other traumatic brain injuries. It is worth noting that traumatic brain injuries vary from a concussion with no significant ongoing problems, to serious accidents where parts of the brain may have been permanently damaged. It is also worth noting that sometimes a child will sustain a knock to the head with no immediately obvious problems, but then start showing changes in behaviour in the following weeks. This can be suggestive of an issue with the head knock, and steps should be taken to reduce any chance of a further head knock while the child recovers. Contact sports such as rugby are classic for head knocks. A concussion that has caused a brain injury can take up to two years to fully resolve, and vulnerability to further damage persists particularly during this period during which the brain is trying to regrow damaged connections.
Information provided on these sites should be considered as only possibly relevant to any individual situation, and where there are any queries, consultation with an appropriate medical or mental health clinician is recommended.
There are a range of other sites which also provide information on head injury or brain injury. Some of those are possibly less reliable than those shown below.
https://www.brain-injury.org.nz/
http://www.headinjurysymptoms.org/
All views expressed in this information sheet are those of the author, however based on broad research and clinical experience. Any feedback may be directed to the author: Steve Williams, Consultant Clinical Psychologist, Director: C&A Hub.
This version: © August 2023.