Infant brain damage will vary depending upon the severity of the injury, and where and how the injury occurred. Although there is a myriad of treatment options for infant damage, what’s right for your infant may not work for another baby. If your infant suffers from brain damage, it’s important to know what treatment choices are available and what would work best for you and your baby. The following treatment options are to be used only as a guideline for the most common treatments used for infants and children with brain damage. However, if you ever have questions or concerns regarding your baby’s treatment, call your physician immediately.
Initial Assessment Before Treatment
In order to understand what treatment will work best, physicians will typically administer a CT scan, an MRI, or both. However, infants and toddlers under two years of age almost always undergo a test in order to determine if they are capable candidates of CT scans. One of the more popular tests, known as the Glasgow Coma Scale, is a neurological scale that assesses the conscious state of the person being tested. For anyone under two years of age, a score of less than 15 must be achieved. If infants or children score 15, CT scans are usually not administered unless the physical symptoms are severe and worsening. In addition, parental recommendation and the experience of the physician may allow those with scores of 15 to still undergo a CT scan. If a CT scan is still not recommended, doctors rely on physical symptoms to assess the severity of brain damage.
Once the initial assessment is completed, doctors have a better understanding of the infant’s brain damage, including the severity of the injury and the areas of the brain that are affected. Treatment will depend upon the results and the severity of the infant’s injuries.
Surgery is most often used for infants who’ve experienced severe head trauma during the delivery period. For instance, if the birth injury caused bleeding in the skull cavity or if there are any broken or bleeding blood vessels and/or skull fractures, surgery can repair the fractures, stop the bleeding, and prevent more damage to the vessels.
There are various types of surgery performed. The type of surgery, again, will depend upon the location and the severity of the injuries. Common surgeries include:
A craniotomy involves removing a bone flap so that doctors can access the brain and repair damages such as bleeding vessels, skull fractures, and large blood clots. A small hole is cut in the brain in order to remove the bone flap. Afterwords, the bone flap is secured back in place with screws and plates.
Decompressive craniectomy is a surgical procedure reserved for people with severe head trauma. Surgeons remove a large portion of the skull so that a brain that’s swelling has room to “breathe.” Although this type of surgery is considered controversial, especially for children and infants, a swelling brain is considered life-threatening and in some instances a decompressive craniectomy is the best option.
According to the National Institutes of Health (NIH), a recent study that followed 23 children who underwent decompressive craniectomies revealed that 81% of the surviving children returned to their normal life functions without daily assistance while another 18% survived, but were dependent upon caregivers for their daily needs. Unfortunately, one child died during the operation and six others died shortly after the operation. Consequently, it’s important to discuss the pros and cons of this type of surgery with your physician before determining if it’s the right choice.
Many infants who are victims to brain damage may have frequent seizures, head pain and swelling, and infections. Physicians usually monitor the baby closely to determine what type of medications would work best. Typical medications for brain injuries include:
- Anti-seizure medications: Anti-seizure medications, such as phenytoin, benzodiazepines, or levetiracetam, helps control spastic movement and seizures.
- Behavioral and concentration medications: Behavorial and concentration medications are typically prescribed when the infant grows older and exhibits common side effects of brain damage, including hyperactivity, attention deficits disorders (ADD or ADHD), and aggression. Common medications include bromocriptine, amitriptyline, and methylphenidate.
- Diuretics: Diuretics promotes an increase in urination, which in turn helps reduce the fluids that built up in the tissues. Most diuretics are administered intravenously; the most common medication for brain damage patients is Mannitol.
As mentioned earlier, infants with brain are likely to develop emotional, cognitive, and even physical disabilities. According to the British Medical Journal (BMJ), disorders including ADD, ADHD, autism, learning disorders, and behavioral problems have a strong correlation with newborn brain injuries. In addition, infants with traumatic brain injuries may need lifelong assistance with physical development, including walking, balance and coordination, standing, sitting down, and daily tasks such as eating, drinking, and feeding themselves.
Physical therapists work with patients to improve and help develop more physical independence by teaching and monitoring a series of exercise and training, which may include:
- Flexibility exercises
- Coordination and balance exercises
- Strength training
- Balance activities that helps children learn to sit and stand successfully
- Thermal treatments and electrical stimulation
- Joint mobilization activities
It’s important to note that there are various physical therapists who offer different treatment options and rehabilitation plans. When choosing a physical therapist for your child, make sure that they are experienced in working with children who suffer from brain damage and/or traumatic brain injuries. Furthermore, the physical therapist should be board-certified as a clinical specialist. Ideally, you should also look for a physical therapist who is a Certified Brain Injury Specialist (CBIS).
Per the Brain Injury Association of America (BIA), occupational therapy helps people overcome challenges that prevent them carrying out daily living tasks. For instance, children with brain damage may need help with
- Using the toilet alone
- Feeding and swallowing
- Grooming and dressing
- Cognitive issues
- Emotional issue
Occupational therapists assess individual problems and then create a plan that will help the patient learn the skills they are lacking in. For instance, infants who need help with feeding may get assistance via a feeding tube until they are old enough to transition to oral feed. An occupational therapist will help teach the child how to eat without a feeding tube through a series of exercise and activities. Another example includes a child with autism or an attention deficit disorder; the therapist will create an individualized plan to help the patient deal with cognitive and emotional challenges. Other occupational therapy treatment includes:
- Neuromusculoskeletal activities
- Rehabilitation for fine motor skills
- Sensory and perpetual processing
- Oral motor skills rehabilitation