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Gillette Children’s Specialty Healthcare offers comprehensive medical, surgical and rehabilitative care for children and teens who experience brain injuries. As the Twin Cities’ only nationally ranked Best Children’s Hospital in pediatric neurology and neurosurgery, we offer exceptional expertise.
Whether a patient experiences a concussion that requires outpatient follow-up care, or a severe brain injury that requires comprehensive inpatient rehabilitation services, Gillette has the specialists, facilities and support services to meet your needs. We also partner with Regions Hospital to provide Minnesota’s first Level I Pediatric Trauma Center—offering the highest level of care for children and teens with serious injuries.
Why Choose Gillette?
- Gillette is one of the nation’s Best Children’s Hospitals in pediatric neurology and neurosurgery.
- We offer outpatient follow-up care and comprehensive inpatient rehabilitation services for children and teens whose injuries range from concussions to severe brain injuries.
- Our facilities and technology help us provide comprehensive care for patients and their families, including patients who use ventilators, have tracheostomies and require tube feeding.
- We offer the nation’s highest concentration of pediatric rehabilitation medicine specialists—experts in the rehabilitation needs of children who sustain brain and other serious injuries.
Types, Causes and Prevention
There are several types of brain injuries. Those that take place before, at, or shortly after birth and result in specific conditions (such as cerebral palsy) are covered elsewhere under Conditions and Care. Those that occur after birth are called acquired brain injuries and are the focus of this section.
Factors that can cause acquired brain injuries include:
- Prolonged lack of oxygen (anoxic brain injury)
- Infections, such as encephalitis or meningitis
- Encephalopathy (including severe dehydration or overhydration, illness of the liver or pancreas, disruption of the heart, and exposure to toxic chemicals or drugs)
- Decreased flow of oxygen (hypoxic injury)
- Brain tumors
- Trauma caused when the head is hit hard or whipped violently back and forth (traumatic brain injury, including concussion)
Most patients who come to Gillette for treatment of brain injuries have experienced traumatic brain injuries (TBIs)—injuries caused by an external force to the brain. In some patients, however, an illness or condition affects the brain from within. Those are called nontraumatic brain injuries.
Although brain injuries range in severity, all are serious and require expert care.
Traumatic Brain Injuries
Traumatic brain injuries (TBIs) are among the most common types of brain injury. They occur when the head is hit hard or whipped violently back and forth. Concussions and related neurotrauma are types of TBIs.
The injuries happen in many ways. For children and teens, the most common causes are:
- Contact sports, such as football, hockey and soccer
- High-risk behaviors and stunts, such as “car surfing” (riding or jumping on top of a moving vehicle) and skitching (riding on a skateboard while being pulled behind a motor vehicle)
- Motor vehicle accidents
- Physical violence and abuse
- Recreational activities, such as biking, in-line skating, skiing and skateboarding
- Serious falls
- Sports with high-speed elements, such as golf or baseball
Mild to moderate TBIs are often called concussions. They typically require outpatient follow-up care and a gradual return to activities, as appropriate. Moderate to severe TBIs cause serious structural injuries to the brain. They usually require hospitalization and comprehensive rehabilitation services to help patients relearn skills.
Anoxic Brain Injury and Hypoxic Injury
A prolonged lack of oxygen (anoxic brain injury) and a decreased flow of oxygen (hypoxic injury) can cause moderate to severe brain injuries, depending on how long a patient is without sufficient oxygen. Both conditions can accompany a traumatic brain injury and other illnesses.
Anoxic Brain Injury
When children can’t breathe—if they are underwater too long, experience cardiac arrest, nearly suffocate, or have their airway blocked by a toy or food—their brain function is impaired. Nerve cells throughout the brain die, damaging part or all of the brain. Children who have been without oxygen for longer periods of time generally experience more disabilities.
Hypoxic injuries differ from anoxic injuries in that a decreased amount of oxygen (rather than no oxygen) goes to the brain. That does not, however, mean a hypoxic brain injury is less severe. Hypoxic injuries affect children differently, depending on how long their brains lack adequate oxygen. Typical causes include carbon monoxide poisoning, nearly drowning, strangling, choking on food, suffocating, cardiac arrest and head trauma.
Nontraumatic Brain Injuries
Nontraumatic brain injuries occur when something from within alters the healthy functioning of the brain. Nontraumatic brain injuries are less common than TBIs.
Many factors can lead to nontraumatic brain injuries, including:
Arteriorvenous malformations (AVMs)
AVMs are abnormal connections, present at birth, between arteries and veins. In some cases, AVMs bleed. Bleeding injures the brain and is considered a form of stroke. Depending on where the bleeding occurs, children can experience difficulties with speech, arm and leg control, understanding, and learning.
Removing a tumor in the posterior fossa (portion of the brain that includes the cerebellum and brain stem) causes an acquired brain injury and a condition called posterior fossa syndrome. Symptoms of the syndrome include the inability to speak or speech that is difficult to understand. Children might have difficulty chewing and swallowing, and they might struggle to move their arms and legs. If the nerves of the face and neck are involved, children will have trouble making facial expressions or opening and closing their eyes. They also might struggle to control emotions.
Encephalopathy is a brain injury that results when other functions of the body are disrupted. Some examples of disruptions include illnesses that include the liver or pancreas, such as diabetes; disruptions to the heart that affect the delivery of oxygen to the brain (anoxia); severe dehydration (loss of fluids) or water accumulating too quickly in the body; environmental toxins, such as leaded paint; and consuming substances such as prescription medicines, alcohol and other drugs.
Epilepsy and Seizures
Children who have epilepsy and a history of seizures are at risk for traumatic brain injury from a blow to the head, anoxic or hypoxic brain injury from drowning or choking, and nontraumatic brain injuries from prolonged seizures.
Infections can cause swelling that damages brain cells. Two common types are encephalitis (inflammation of the brain) and meningitis (inflammation of the membranes covering the brain and spinal cord), both of which are usually caused by a virus or bacteria. Depending on where the injury occurs, encephalitis can cause a variety of problems, including learning difficulties, speech and language challenges, memory loss, reduced muscle control, and problems with balance and coordination.
Childhood strokes might result from brain malformations, infections (such as encephalitis or meningitis), trauma or blood disorders. Depending on the cause and location of the stroke, children might have difficulty with speech and movement on one half of the body. Communication can be severely affected if the stroke occurs in the left side of the brain. If bleeding is severe, children might experience epilepsy and significant cognitive challenges.
Symptoms and Effects
Traumatic brain injuries (TBIs)—the most common type of acquired brain injury—damage cells, blood vessels and nerves in the brain, causing a wide variety of symptoms. Symptoms range in severity based on what part of the brain is affected and the extent of the damage.
- Dizziness and/or trouble with balance
- Nausea and vomiting
- Numbness and/or tingling
- Sensitivity to noise
- Visual problems and/or sensitivity to light
- Changes in school performance
- Difficulty concentrating
- Difficulty remembering
- Feeling foggy, slowed down, dazed or stunned
- Forgetting or feeling confused about recent events
- Repeating questions and/or answering them more slowly than usual
- Feeling more emotional than usual
- Showing less interest in favorite activities
Sleep and Energy Symptoms
- Having trouble falling asleep or staying asleep
- Sleeping more or less than usual
Symptoms in Infants and Young Children
Because young children can’t tell you how they feel, it can be difficult to recognize symptoms in infants and toddlers. In addition to the above symptoms, look for:
- A soft spot on the scalp or swelling of the scalp
- Changes in play or decreased interest in favorite activities
- Excessive crying
- Listlessness (child feels “floppy” in your arms and doesn’t play or grab objects)
- Loss of new skills, such as walking or toilet training.
- Refusal to eat or nurse
Diagnosis and Tests
A medical professional should evaluate children immediately after any type of brain injury. Depending on the severity of the injury, initial evaluations often take place in urgent care settings, emergency rooms or trauma centers.
Mild to Moderate Injuries (Concussions)
- Computed tomography (CT) scans
- ImPACT (Immediate Postconcussion Assessment and Testing)
- Magnetic resonance imaging (MRI) tests
- Neurological evaluations (by a nurse practitioner or pediatric neurologist)
- Neuropsychological evaluations
Moderate to Severe Injuries
For moderate to severe injuries, Gillette provides expert evaluations, comprehensive inpatient rehabilitation services, and skilled outpatient follow-up care. We partner with Regions Hospital to provide Minnesota’s first Level I Pediatric Trauma Center.
Children who have moderate to severe brain injuries might undergo:
Treatments and Rehabilitation
Treatment and rehabilitation vary following a traumatic brain injury, depending on the severity of the injury and its effects. At Gillette, we offer expert care for injuries ranging from concussions to severe brain injuries.
Concussions and Related Neurotrauma
Gillette’s Neurotrauma Clinic offers outpatient follow-up care for concussions and related neurotrauma, such as whiplash and sports injuries that affect the nerves in the neck and shoulders.
Moderate to Severe Brain Injuries
Gillette’s Center for Pediatric Rehabilitation provides comprehensive inpatient rehabilitation services and expert outpatient rehabilitation care for patients who have moderate to severe brain injuries. Our comprehensive team of specialists provides medical, surgical, rehabilitation and assistive technology services. We focus on helping patients relearn skills and return to their homes and communities.
Brain injuries can cause a wide range of effects. That’s why we offer comprehensive services and a family-centered approach to care. At Gillette, families can count on an exceptional team, a well-designed environment, and a focus on helping patients participate as fully as possible in their homes, schools and communities.
At Gillette, care for patients who experience brain injuries most often involves the areas of:
- Child life
- Radiology and imaging
- Rehabilitation medicine
- Rehabilitation therapies
- Social work
- Therapeutic recreation
For more information about the comprehensive services we provide at Gillette, search Conditions and Care.
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